Disappointing mid-term results after laparoscopic gastric banding in young patients.
BACKGROUND
When gastric banding was introduced as a bariatric operation about 12 years previously, its early results were promising, with a low complication rate. Only a few long-term studies on this subject have been published. This study was performed to assess our results with laparoscopic gastric banding in young patients after<or=10 years of follow-up.


METHODS
From January 1996 to December 2000, a total of 41 patients (83% female, 17% male)<25 years old underwent laparoscopic gastric banding at our institution. The patient data were derived from the electronic patient data system, paper charts, and a telephone interview. Psychosocial changes were analyzed using the Moorehead-Ardelt/Bariatric Analysis and Reporting Outcome System questionnaire.


RESULTS
The mean preoperative body mass index was 44.26+/-6.53 kg/m2, with a mean excess weight of 65.22+/-20.48 kg. The body mass index after 1, 5, and 7 years was 31.50+/-7.38 kg/m2, 31.12+/-7.10 kg/m2, and 32.88+/-5.68 kg/m2, respectively. The mean excess weight loss after 1 year was 60.07%+/-25.33%, and after 5 and 7 years, it was 64.84%+/-27.45% and 57.48%+/-28.07%, respectively. An improvement in obesity-related co-morbidities was observed in nearly all patients. Of our patients, 52% had complications requiring reoperation (27% pouch dilation, 10% band leakage, 5% intragastral band migration, 5% perforation of either the esophagus or the stomach, and 5% port disconnection). According to Bariatric Analysis and Reporting Outcome System, the long-term outcome was regarded as a failure in 40%, fair in 4%, good in 28%, very good in 20%, and excellent in 8% of patients.


CONCLUSIONS
Our mid-term results were disappointing, with a high complication rate and many dissatisfied patients.
Department of General and Transplant Surgery, Innsbruck Medical University Hospital, Innsbruck, Austria.
Monika
M
Lanthaler
Michael
M
Sieb
Stefan
S
Strasser
Helmut
H
Weiss
Franz
F
Aigner
Hermann
H
Nehoda
D000328:Adult; D001317:Austria / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000009:adverse effects* / Q000295:instrumentation; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D015995:Prevalence; D011594:Psychometrics / Q000379:methods; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult