A 10-year Experience with Laparoscopic Gastric Banding for Morbid Obesity: High Long-Term Complication and Failure Rates

Abstract

LGB appeared promising during the first few years after its introduction, but results worsen over time, despite improvements in the operative technique and material. Only about 60% of the patients without major complication maintain an acceptable EWL in the long term. Each year adds 3-4% to the major complication rate, which contributes to the total failure rate. With a nearly 40% 5-year failure rate, and a 43% 7-year success rate (EWL >50%), LGB should no longer be considered as the procedure of choice for obesity. Until reliable selection criteria for patients at low risk for long-term complications are developed, other longer lasting procedures should be used.

Bariatric Surgery in Patients With Morbid Obesity and Type 2 Diabetes

“…The failure rate increased from 13.2% after 18 months to 36.9% at 7 years. According to the experience of the Swiss authors with a 5-year failure rate of 37% and 7-year success rate (excess weight loss Ͼ50%) in only 43%, LAGB should no longer be con-sidered as the procedure of choice for obesity (54). On the other hand, a longterm follow-up study of 342 severely obese patients who underwent gastric bypass in New Zealand (55) showed excellent long-term outcomes.…”

“…Male sex may lead to more complications due to increased technical difficulty caused by a higher BMI, more visceral fat, and potentially more advanced comorbidities (47)(48)(49). In the U.S. (52), in various European countries (53,54), as well as in New Zealand (55), ϳ80% of bariatric surgery patients are women. The proportion of men undergoing bariatric surgery does not reflect the sex distribution of morbid obesity.…”

Past, present, and future: Critical analysis of use of gastric bands in obese patients

“…• Liquids should be zero calories and noncarbonated: [48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64] ounces should be consumed daily to maintain adequate hydration status.…”

“…[59][60][61][62][63][64][65][66][67][68][69][70] Band slippage or band prolapse occurs when part of the stomach herniates through the band at the top of the stomach. This occurs in about 4% (1.0%-6.5%) of patients in recent studies, with older studies showing a much higher rate of this complication.…”

Laparoscopic bariatric gastro bypass with the use of adjustable gastric band for gastric separation, with manual gastroenteroanastomosis

“…Для разделения органа циркулярно вокруг желудка используют промышленно выпускаемый силиконо-вый биоинертный регулируемый бандаж «Медсил», герметично и дозированно пережимающий желудок и делящий его на 2 части -малую и большую. Как известно, силиконовый регулируемый желудочный бандаж в мировой медицине успешно используется более 40 лет [6].…”