Band erosion after laparoscopic gastric banding: a retrospective analysis of 865 patients over 5 years

Abstract

The overall incidence of LAGB erosions in our series was 1.96%. This incidence fell with increasing experience to 0.5% after the initial 300 bands were excluded from the analysis (3 band erosions in the last 565 band insertions). However, further increases in incidence are likely with a longer follow-up period. The most common presentation was abdominal pain followed by weight regain and port-site sepsis. In the authors' hands, laparoscopic omental plugging and band removal through a separate anterior gastrotomy appear to be effective methods for dealing with band erosions. Band erosion is a significant source of morbidity, with at least one-third of the erosion patients in our series not achieving their final goal of weight loss despite appropriate treatment. This study highlights the need for a future prospective randomized study to clarify the apparent strong influence of band design and construction on the etiopathogenesis of band erosion.

Complications from Laparoscopic Adjustable Gastric Banding: 364 Cases Experience

“…A multiple regression analysis shows that erosion rate is signifi cantly predicted by number of patients and number of years of surgeon experience. As stated by Cherian et al [18], 55% of the erosions occur within the fi rst year, and only 10% after the second year of LAGB placement, the gastric band erosion can be as high as 17% in reports involving less than 100 patients. It has been generally accepted that early GBE is related to micro-injury during surgery, while late GBE is linked to foreign body responses caused by chronic ischemic tissue damage, however, the etiology of GBE is still not understood at all.…”

Intragastric gastric band migration: erosion: an analysis of multicenter experience on 177 patients

“…Christou and Efthimiou [19] reported six erosions observed during the first 18 months after surgery. Cherian et al [6] reported presentation of erosion in 10/17 patients during the first year and only 2 after the second year from band positioning. These authors support the hypothesis that intragastric migration is multifactorial, suggesting a different etiology depending on the timing of complication: early erosion could be related to iatrogenic microinjuries at the time of band insertion, while a delayed appearance could be due to a combination of insults to the gastric serosa, including ischemia and foreign body reaction or high internal pressure as a result of ingestion of excessively large food boluses early after surgery.…”

“…Hypovolemic shock with massive upper gastrointestinal hemorrhage due to erosion into the celiac axis or in the left gastric artery has been reported, as well as small bowel obstruction due to intragastric band erosion [24][25][26]. In most cases, clinical symptoms are absent or mild and transient, and many authors agree that a pathognomonic manifestation of intragastric erosion is absent [1][2][3][4][5][6]14].…”

“…Cherian et al [6], in a study of 17 of 865 patients, indicated that the most common symptom was the epigastric pain (61 %) followed by ''loss of weight loss'' or weight regain (55.6 %) and by port-site or occult sepsis (44 %). Less common presentations were dysphagia, hematemesis, and early satiety.…”

“…For this reason it is nowadays one of the most popular techniques for the surgical treatment of obesity [1][2][3]. Despite these advantages, its long-term efficacy has come into question because of complications such as gastric pouch dilation and intragastric band migration directly linked to the erosion of the gastric wall caused by the prosthesis [4][5][6].…”