title: Laparoscopic placement of adjustable gastric band in patients with autoimmune disease or chronic steroid use.
abstract: BACKGROUND
  Past medical or family history of autoimmune diseases and patient chronic steroid use are label contraindications for laparoscopic placement of adjustable gastric band (LAGB). We reviewed our experience with placement of LAGB in patients with autoimmune disease or chronic steroid use.
  
  
  METHODS
  This was a retrospective review of our prospective bariatric database. All patients who underwent LAGB and had a diagnosis of autoimmune disease or chronic steroid use with at least 1-year follow-up data were included in the study. Data on demographics, weight loss, and complications were collected.
  
  
  RESULTS
  Sixteen patients with autoimmune diseases or chronic steroid use underwent LAGB. Diseases included were lupus (n = 6), sarcoidosis (n = 4), renal transplant (n = 2), rheumatoid arthritis (n = 1), ulcerative colitis (n = 1), Grave's disease (n = 1), and celiac disease (n = 1). No patients developed infectious complications. One patient required port replacement due to malfunction, and one patient underwent a conversion to gastric bypass due to failure of weight loss. The average preoperative body mass index was 46.8 kg/m(2) with an average weight of 292.0 lbs. Average excess weight loss was 39.8 % (range, 7.4 to 95.5 %) at a median follow-up of 54 months.
  
  
  CONCLUSIONS
  Our review indicates that LAGB in patients with autoimmune diseases or chronic steroid use is safe, with no infectious complications and only one explant. Some of these autoimmune conditions may improve following significant weight loss, but larger studies are required to further substantiate these findings.
authors.affiliation: Department of Surgery, Texas Tech University Health Sciences Center, 3601 Fourth St, Lubbock, TX, 79430, USA, paul.delprado@ttuhsc.edu.
authors.forename: Paul
authors.initials: P
authors.lastname: Del Prado
authors.forename: Pavlos K
authors.initials: PK
authors.lastname: Papasavas
authors.forename: Darren S
authors.initials: DS
authors.lastname: Tishler
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Stone
authors.forename: Janet S
authors.initials: JS
authors.lastname: Ng
authors.forename: Sean B
authors.initials: SB
authors.lastname: Orenstein
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D001327:Autoimmune Diseases / Q000150:complications / Q000188:drug therapy*; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D015391:Gastroplasty; D006084:Graft Rejection / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents