The effect of gastric band slippage on patient body mass index and quality of life.
BACKGROUND
Laparoscopic adjustable gastric banding (LAGB) is a popular surgical procedure for the management of morbid obesity. Gastric band slippage (GBS) is the most common long-term complication. In this study, the effect of GBS on body mass index (BMI) and quality of life (QOL) were assessed.


METHODS
This was a retrospective, case-controlled study. Patient demographics and BMI were prospectively recorded, and QOL was assessed via telephone questionnaire using the medical outcomes study short-form-36 (SF-36). The QOL of the GBS group were compared with an age, sex, and duration of follow-up matched control group who underwent uncomplicated LAGB (n = 10).


RESULTS
Seventeen patients with GBS who underwent surgery were identified. Ten patients underwent band removal, and seven underwent revision surgery (six band repositioning and one Roux-en-Y gastric bypass); all were managed laparoscopically. Mean follow-up since re-operation was 17.2 ± 2.9 months. A significant increase in BMI occurred following GBS surgery (29.0 ± 1.5 vs. 33.8 ± 1.0, P = 0.035), which did not differ between the removal or revision groups. Overall, there was no difference in QOL between the GBS and control groups. On subgroup analysis, those who underwent revision surgery had a worse score in limitations in social activities because of physical or emotional problems than those who underwent band removal (92.0 ± 3.9 vs. 70.8 ± 10.0, P = 0.046).


CONCLUSIONS
Following surgery for GBS, patients experience a rise in BMI. Overall, this does not affect patient QOL but may limit social activities because of physical or emotional problems in those who have band revision surgery.
Department of Surgery, St Columcille's Hospital, Loughlinstown Co, Dublin, Ireland.
Shaheel M
SM
Sahebally
John P
JP
Burke
Donal
D
O'Shea
Justin
J
Geoghegan
D000328:Adult; D015992:Body Mass Index; D016022:Case-Control Studies; D020878:Device Removal; D005260:Female; D005500:Follow-Up Studies; D005548:Foreign-Body Migration; D015391:Gastroplasty / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D009767:Obesity, Morbid / Q000523:psychology / Q000601:surgery*; D011788:Quality of Life; D012086:Reoperation; D012189:Retrospective Studies; D017211:Treatment Failure