title: Laparoscopic adjustable gastric banded plication: evolution of procedure and 2-year results.
abstract: BACKGROUND
  Laparoscopic adjustable gastric banded plication (LAGBP) is a new restrictive bariatric procedure combining adjustable banding and greater curvature plication of the stomach. This study aimed to report the evolution of this surgical technique and analyze the surgical results.
  
  
  METHODS
  Eighty patients who underwent LAGBP were enrolled in this study. The band-first technique was used in 50 patients from May 2009 to June 2011 and was then changed to the plication-first technique from July 2011 to October 2011. Patients' demographics and pre- and postoperative data, including complications and weight loss, were collected and analyzed.
  
  
  RESULTS
  Eighty patients (26 men and 54 women) with a mean age of 30.75 ± 8.68 years and a mean body mass index of 38.05 ± 4.73 kg/m2 were evaluated with a mean follow-up of 10.52 (1-24) months. The average operation duration and hospital stay were 92.85 ± 35.86 min and 1.73 ± 1.04 days, respectively. No intraoperative complications or surgical mortality was observed in this series. Four (8%) postoperative complications occurred with the band-first technique and one (3%) with the plication-first technique. Mean excess weight loss (percentage) at 6, 12, 18, and 24 months were 42.59 ± 13.67, 56.38 ± 19.89, 57.59 ± 19.88, and 65.84 ± 17.36%, respectively. The frequency of band adjustment was 2.44 ± 2.21 times in 2 years.
  
  
  CONCLUSIONS
  In this present 2-year result, LAGBP using plication-first technique revealed fewer complications and good weight loss. Longer follow-up is still necessary to be accepted as a stand-alone bariatric procedure.
authors.affiliation: Bariatric and Metabolic International (B.M.I) Surgery Centre, Department of General Surgery, E-Da Hospital, 1, E-Da Rd, Jian-Shu Tsuen, Yan-Chau Shiang, Kaohsiung, 824, Taiwan, Republic of China.
authors.forename: Satish
authors.initials: S
authors.lastname: Pattanshetti
authors.forename: Chi-Ming
authors.initials: CM
authors.lastname: Tai
authors.forename: Yung-Chieh
authors.initials: YC
authors.lastname: Yen
authors.forename: Hung-Yen
authors.initials: HY
authors.lastname: Lin
authors.forename: Shu-Ching
authors.initials: SC
authors.lastname: Chi
authors.forename: Chih-Kun
authors.initials: CK
authors.lastname: Huang
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods / Q000639:trends; D006801:Humans; D010535:Laparoscopy; D008297:Male; D009767:Obesity, Morbid / Q000401:mortality / Q000601:surgery*; D011184:Postoperative Period; D012086:Reoperation; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss