title: Long-term outcomes of laparoscopic adjustable gastric banding.
abstract: OBJECTIVE
  To determine the long-term efficacy and safety of laparoscopic adjustable gastric banding (LAGB) for morbid obesity.
  
  
  METHODS
  Clinical assessment in the surgeon's office in 2009 (≥12 years after LAGB).
  
  
  METHODS
  University obesity center in Brussels, Belgium.
  
  
  METHODS
  A total of 151 consecutive patients who had benefited from LAGB between January 1, 1994, and December 31, 1997, were contacted for evaluation.
  
  
  METHODS
  Laparoscopic adjustable gastric banding.
  
  
  METHODS
  Mortality rate, number of major and minor complications, number of corrective operations, number of patients who experienced weight loss, evolution of comorbidities, patient satisfaction, and quality of life were evaluated.
  
  
  RESULTS
  The median age of patients was 50 years (range, 28-73 years). The operative mortality rate was zero. Overall, the rate of follow-up was 54.3% (82 of 151 patients). The long-term mortality rate from unrelated causes was 3.7%. Twenty-two percent of patients experienced minor complications, and 39% experienced major complications (28% experienced band erosion). Seventeen percent of patients had their procedure switched to laparoscopic Roux-en-Y gastric bypass. Overall, the (intention-to-treat) mean (SD) excess weight loss was 42.8% (33.92%) (range, 24%-143%). Thirty-six patients (51.4%) still had their band, and their mean excess weight loss was 48% (range, 38%-58%). Overall, the satisfaction index was good for 60.3% of patients. The quality-of-life score (using the Bariatric Analysis and Reporting Outcome System) was neutral.
  
  
  CONCLUSIONS
  Based on a follow-up of 54.3% of patients, LAGB appears to result in a mean excess weight loss of 42.8% after 12 years or longer. Of 78 patients, 47 (60.3%) were satisfied, and the quality-of-life index was neutral. However, because nearly 1 out of 3 patients experienced band erosion, and nearly 50% of the patients required removal of their bands (contributing to a reoperation rate of 60%), LAGB appears to result in relatively poor long-term outcomes.
authors.affiliation: The European School of Laparoscopic Surgery, Department of Gastrointestinal Surgery, Saint Pierre University Hospital, Brussels, Belgium. jacques_himpens@hotmail.com
authors.forename: Jacques
authors.initials: J
authors.lastname: Himpens
authors.forename: Guy-Bernard
authors.initials: GB
authors.lastname: Cadière
authors.forename: Michel
authors.initials: M
authors.lastname: Bazi
authors.forename: Michael
authors.initials: M
authors.lastname: Vouche
authors.forename: Benjamin
authors.initials: B
authors.lastname: Cadière
authors.forename: Giovanni
authors.initials: G
authors.lastname: Dapri
mesh_terms: D000328:Adult; D000368:Aged; D001530:Belgium / Q000453:epidemiology; D015992:Body Mass Index; D015897:Comorbidity / Q000639:trends; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology*; D011788:Quality of Life; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012891:Sleep Apnea Syndromes / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss