Changes in Outcomes, Satiety and Adverse Upper Gastrointestinal Symptoms Following Laparoscopic Adjustable Gastric Banding.
Patient-reported outcomes and perceptions are critical to the overall efficacy and acceptability of a surgical procedure. Outcomes, such as patient satisfaction and perceived success of the surgery and adverse symptoms, have not been described in detail following bariatric surgery. The associations and predictors of patient satisfaction have not been defined. This study aimed to examine long-term outcomes and perceptions after laparoscopic adjustable gastric banding (LAGB).



We conducted a prospective study of outcomes, satiety and adverse upper gastrointestinal symptoms, as well as quality of life and subjective patient satisfaction in LAGB patients. Data were collected at 3 years (T1) and 8 years post-operatively (T2).



One-hundred and sixty patients completed follow-up at T1 and T2. The average age was 44.0 ± 11.2 years. At T2, the total body weight loss was 17.8 ± 11.9 %. Satisfaction decreased significantly between time points (8.6 ± 1.8 vs 7.2 ± 2.9, p < 0.01), and quality of life reduced slightly across all domains. Hunger scores remained low (3.8 ± 1.8 vs 3.9 ± 1.8, p = 0.61). The dysphagia score did not change significantly (p = 0.54). There was minimal change in frequency of regurgitation, although there was significant increase in patient assessment of how bothered they were by regurgitation. Multivariate analysis identified increased awareness of regurgitation as a principal driver of reduced satisfaction.



Weight loss, satiety and adverse symptoms demonstrated only slight changes between 3 and 8 years post-operatively. Despite this, overall satisfaction and perception of success of the procedure reduced markedly. This appeared mediated by reduced tolerance of adverse symptoms. These data inform follow-up practises aimed at optimizing outcomes.
Centre for Obesity Research and Education (CORE), Monash University, Level 6, 99 Commercial Road, Prahran, Melbourne, VIC, 3181, Australia. paul.burton@monash.edu.|Alfred Hospital Upper Gastrointestinal Surgical Unit, The Alfred Hospital, Prahran, Melbourne, Australia. paul.burton@monash.edu.
Paul R
PR
Burton
Centre for Obesity Research and Education (CORE), Monash University, Level 6, 99 Commercial Road, Prahran, Melbourne, VIC, 3181, Australia.
Geraldine J
GJ
Ooi
Centre for Obesity Research and Education (CORE), Monash University, Level 6, 99 Commercial Road, Prahran, Melbourne, VIC, 3181, Australia.
Cheryl
C
Laurie
Centre for Obesity Research and Education (CORE), Monash University, Level 6, 99 Commercial Road, Prahran, Melbourne, VIC, 3181, Australia.
Margaret
M
Anderson
Centre for Obesity Research and Education (CORE), Monash University, Level 6, 99 Commercial Road, Prahran, Melbourne, VIC, 3181, Australia.
Katrina
K
Parker
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.|Clinical Haematology Department, The Alfred Hospital, Prahran, Melbourne, Australia.
Eldho
E
Paul
Department of Gastroenterology and University of Melbourne, The Royal Melbourne Hospital, Parkville, Australia.
Geoff
G
Hebbard
Centre for Obesity Research and Education (CORE), Monash University, Level 6, 99 Commercial Road, Prahran, Melbourne, VIC, 3181, Australia.
Paul E
PE
O'Brien
Centre for Obesity Research and Education (CORE), Monash University, Level 6, 99 Commercial Road, Prahran, Melbourne, VIC, 3181, Australia.|Alfred Hospital Upper Gastrointestinal Surgical Unit, The Alfred Hospital, Prahran, Melbourne, Australia.
Wendy A
WA
Brown
D000328:Adult; D003680:Deglutition Disorders / Q000209:etiology; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology*; D015391:Gastroplasty / Q000009:adverse effects*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D017060:Patient Satisfaction; D011184:Postoperative Period; D011446:Prospective Studies; D011788:Quality of Life; D012527:Satiation; D016896:Treatment Outcome; D015431:Weight Loss
Adjustable gastric band; Bariatric surgery; Dysphagia; Outcomes; Quality of life; Regurgitation; Satiety