title: Long-Term Results After Laparoscopic Adjustable Gastric Banding for Morbid Obesity: 18-Year Follow-Up in a Single University Unit.
abstract: Laparoscopic adjustable gastric banding (LAGB) remains one of the most performed bariatric procedures worldwide, but a few long-term studies have been reported often with limited data at time of longest follow-up. We review our 18-year LAGB experience with special regard to weight loss failure and long-term complications leading to band removal.
  
  
  
  We performed 897 LAGB procedures from April 1996 to December 2007: 376 using the perigastric dissection and 521 using the pars flaccida dissection. We performed a retrospective analysis of the data of this consecutive series. Failure was defined as band removal with or without conversion to another procedure or excess weight loss (EWL%) <25 %.
  
  
  
  There were 120 men and 770 women. Mean age was 39.5 years, and mean BMI was 45.6 kg/m2. Mean follow-up was 14.6 years (range 101-228 months) with 90 % follow-up beyond 10 years. Ten (1.1 %) had early complications and 504 (56 %) late complications. Overall, 374 (41.6 %) bands were explanted for complications, weight regain, or intolerance. Mean 15-year EWL% in patients with band in place was 41.73 %. Over time, band failure rate increases from 18.4 % at 2 years to 43 % at 10 years and more than 70 % beyond 15 years.
  
  
  
  Despite good initial results, late complications, weight regain, and intolerance lead to band removal in nearly half of the patients over time. However, given that there is no good information on alternative procedures in the long term and considering its reversibility and safety still has a place in the treatment of morbid obesity for informed and motivated patients.
authors.affiliation: Department of General and Visceral Surgery, Bichat-Claude Bernard University Hospital, Paris, France. konstarapis@hotmail.com.
authors.forename: K
authors.initials: K
authors.lastname: Arapis
authors.affiliation: Department of General and Visceral Surgery, Bichat-Claude Bernard University Hospital, Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Tammaro
authors.affiliation: Department of General and Visceral Surgery, Bichat-Claude Bernard University Hospital, Paris, France.
authors.forename: L Ribeiro
authors.initials: LR
authors.lastname: Parenti
authors.affiliation: Department of Hepato-Gastroenterology, Bichat-Claude Bernard University Hospital, Paris, France.
authors.forename: A L
authors.initials: AL
authors.lastname: Pelletier
authors.affiliation: Department of General and Visceral Surgery, Bichat-Claude Bernard University Hospital, Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: Chosidow
authors.affiliation: Department of General and Visceral Surgery, Bichat-Claude Bernard University Hospital, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Kousouri
authors.affiliation: Team REGLYS University of Paris-CNRS, UMR8251, Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Magnan
authors.affiliation: Team of Diabetes Vascular Complication Cordelier Recherche Center, Department of Diabetes and Nutrition Bichat-Claude Bernard University Hospital, Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Hansel
authors.affiliation: Department of General and Visceral Surgery, Bichat-Claude Bernard University Hospital, Paris, France.
authors.forename: J P
authors.initials: JP
authors.lastname: Marmuse
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000379:methods / Q000534:rehabilitation; D006785:Hospitals, University; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000534:rehabilitation / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
keywords: Laparoscopic gastric banding; Long-term complications; Long-term results; Morbid obesity; Revisional surgery