National trends in use and outcome of laparoscopic adjustable gastric banding.
BACKGROUND
Laparoscopic adjustable gastric banding is gaining popularity in the United States. Our objective was to examine the use and outcomes of laparoscopic adjustable gastric banding at academic medical centers.


METHODS
Using the "International Classification of Diseases, Ninth Revision" diagnosis and procedure codes, data were obtained from the University Health System Consortium Clinical Database for all laparoscopic adjustable gastric banding and gastric bypass procedures performed from 2004 to 2007. Quartile trends in the use of all procedures were determined, and a comparison of in-hospital morbidity and mortality between laparoscopic adjustable gastric banding and laparoscopic gastric bypass was performed.


RESULTS
A total of 31,333 bariatric surgery procedures were performed from 2004 to 2007. During this period, the use of laparoscopic adjustable gastric banding and gastric bypass procedures increased from 7% to 23% and 53% to 66%, respectively. A concurrent decrease occurred in the use of open gastric bypass procedures from 40% to 11%. Compared with laparoscopic gastric bypass, laparoscopic adjustable gastric banding was associated with a significantly shorter length of stay (1.3 versus 2.7 d, P<.01), lower morbidity (2.8% versus 7.5%, P<.01), lower 30-day readmission rate (.7% versus 2.5%, P<.01), lower in-hospital mortality (.02% versus .08%, P<.01), and lower hospital cost ($8689 versus 14,386, P<.01).


CONCLUSIONS
From 2004 to 2007, significant growth occurred in the number of laparoscopic adjustable gastric banding (+329%) and laparoscopic gastric bypass (+125%) procedures, with a precipitous decrease in the number of open gastric bypass (-73%) procedures. The increasing popularity of the laparoscopic adjustable gastric band procedure could in part be related to the lower cost and lower morbidity compared with laparoscopic gastric bypass.
Department of Surgery, University of California, Irvine Medical Center, Orange, California 92868, USA.
Marcelo W
MW
Hinojosa
J Esteban
JE
Varela
Dhavan
D
Parikh
Brian R
BR
Smith
Xuan-Mai
XM
Nguyen
Ninh T
NT
Nguyen
D000293:Adolescent; D000328:Adult; D000368:Aged; D004867:Equipment Design; D005260:Female; D015390:Gastric Bypass / Q000191:economics / Q000706:statistics & numerical data; D015391:Gastroplasty / Q000191:economics / Q000295:instrumentation* / Q000706:statistics & numerical data*; D017721:Hospital Costs / Q000639:trends; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D010535:Laparoscopy / Q000191:economics / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000191:economics / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D014600:Utilization Review / Q000706:statistics & numerical data*; D055815:Young Adult