Migration of adjustable gastric banding from a cohort study of 4236 patients

Nocca, David; Frering, Vincent; Gallix, B.; Hons, Charles de Seguin des; Noe͏̈l, Patrick; Foulonge, M. A. Pierredon; Millat, Bertrand; Fabré, J

doi:10.1007/s00464-004-2183-6

Cited by 91 publications

(72 citation statements)

References 24 publications

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“…Other factors that may play a role in band erosions include serosal injury during insertion, use of nonsteroidal anti-inflammatory agents, increased pressure within the band, and excessive vomiting. 71,79,80 Any patient who presents with a late port site wound infection should be investigated with an upper endoscopy to rule out intragastric band migration, as this is a well-described presentation for this complication. Other symptoms may include sudden weight regain, abdominal pain, bleeding, or peritonitis.…”

Section: Dovepressmentioning

confidence: 99%

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

Snyder¹,

Worley²,

Aluka³

et al. 2010

DMSO

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Adjustable gastric banding (AGB) is quickly becoming the most popular bariatric operation performed in the United States and Canada. Patients are particularly fond of the simplicity of the tool, the relatively low morbidity of the surgery, the quick recovery, and overall results. The gastric band has evolved over its 35-year history into a very successful adjustable tool used to restrict food consumption and limit caloric intake. The percent of excessive weight loss after banding can range from 30%-60% and depends on the time out from surgery. Along with weight loss, there is good resolution of the co-morbid conditions that are associated with excess weight and improvements in quality of life demonstrated after banding. Nutrition and follow up are extremely important after banding to ensure good compliance and adequate weight loss. Failure to follow the postoperative diet, exercise regiment, or mechanical failure of the band can lead to failure to lose adequate weight. While there are particular early and late complications associated with this surgery, the safety profile of the AGB is very appealing when compared to other bariatric operations. As we continue to reduce the morbidity of the procedure, the simple adjustable band concept has a lot of potential to remain a primary technique of maintaining long term weight loss. In conclusion, AGB has and continues to play an important role in the treatment of morbid obesity. It offers reasonably good weight loss results with very little morbidity, and the future of the adjustable band is bright.

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Section: Dovepressmentioning

confidence: 99%

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

Snyder¹,

Worley²,

Aluka³

et al. 2010

DMSO

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“…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].…”

Section: Discussionmentioning

confidence: 99%

“…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].…”

Section: Introductionmentioning

confidence: 99%

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

Lorenzo

Furbetta

et al. 2012

Surg Endosc

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Background Laparoscopic adjustable gastric banding (LAGB) has proven to be a safe and effective surgical treatment for morbid obesity. It can be a simple, fast, reversible, anatomy-preserving procedure. Despite these advantages, its long-term efficacy came into question by the occurrence of complications such as intragastric band migration. Consistent information regarding this complication is still lacking. Treatment for migration is still being debated as well. Most of the inconsistencies of these data stem from the very low number of patients reported in single-center experiences or case reports. Lack of multicenter experience is evident. The aim of this study was to perform a retrospective analysis of data on intragastric migration in a large multicenter cohort of patients who underwent LAGB. Methods A retrospective multicenter study on LAGB patients was performed. Data had been entered into a prospective database of the Italian Group for LapBand Ò (GILB) since January 1997. Pars flaccida and perigastric positioning were considered along with different kinds of gastric bands by the same manufacturer. Time of diagnosis, mean body mass index (BMI), presentation symptoms, and conservative and surgical therapy of intragastric migration were considered. Results From January 1997 to December 2009, a total of 6,839 patients underwent LAGB and their data were recorded [5,660 females, 1,179 males; mean age 38.5 ± 18.2 years (range 21-62 years); mean BMI = 46.7 ± 7.7 kg/m 2 (range 37.3-68.3); excess weight (EW) 61.8 ± 25.4 kg (range 36-130); %EW 91.1 ± 32.4 % (range 21-112 %)]. A total of 177 of 6,839 (2.5 %) intragastric erosions were observed. According to the postoperative time of followup, the diagnosis of intragastric migration was made in 74 (41.8 %), 14 (7.9 %), 38 (21.4 %), 40 (22.6 %), 6 (3.4 %), and 4 (2.2 %) banded patients at 6-12, 24, 36, 48, 60, and 72 months after banding, respectively. Most of intragastric band migration during the first 2 years occurred in bands with no or a few milliliters of filling. In patients with late erosion, the bands were adjusted several times; no band was overfilled but one was filled to the maximum or submaximum with a maximum of two adjustments. Erosions diagnosed during the first 24 months were related to the experience of the surgical staff, while late erosions were not. Conclusions Intragastric band migration or band erosion is a rare, disturbing, and usually not life-threatening complication of gastric banding. Its pathogenesis is probably linked to different mechanisms in early (technical failure in retrogastric passage) or late (band management) presentation. It is usually asymptomatic and there is no pathognomonic presentation. A wide range of therapeutic options are available, from simple endoscopic or laparoscopic removal to early or late band replacement or other bariatric procedure. More experience and more studies are needed to lower its presentation rate and definitively clarify its pathogenesis to address the right therapeutic option.

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“…A long-term loss of excess weight of more than 50% is commonly reported, equal to a decrease in BMI with eight to 12 points [4][5][6][7][8][9]. In contrast with operations based on malabsorption, the LAGB respects the normal human anatomy and is theoretically reversible [3,9].…”

Section: Discussionmentioning

confidence: 99%

“…A multitude of case reports exist on this item, varying from a visible gastric band at endoscopy till total band migration and obstruction of the small bowel [16,17]. Treatment by removal of the band is mandatory and can be done by laparoscopy or endoscopy [8,14,18].…”

Section: Discussionmentioning

confidence: 99%

A Rare Complication After Laparoscopic Gastric Banding: Connecting-Tube Penetration into the Hilus of the Kidney

et al. 2008

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Laparoscopic adjustable gastric banding is a common operation for morbid obesity. Late complications mainly originate from either the injection port (dislocation, infection, leakage) or the gastric band (pouch dilatation, slippage, leakage, gastric erosion). Complications from the tube, connecting the port with the band, are rarely described. We report the penetration of a loose connecting tube into the kidney 8 months after removal of an infected injection port. Keywords Gastric banding . Complication . Tubing . Migration Case ReportA 46-year-old obese female patient presented herself with pain in the left side of her abdomen and back. Her medical history consisted of diabetes, hypercholesterolemia, appendectomy, and laparoscopic cholecystectomy. She had a laparoscopic adjustable gastric banding (LAGB) placement 1.5 years prior to presentation. This procedure was complicated after 10 months by dislocation of the reservoir, which was surgically refixed. Eight months before presentation, she developed an infection at the site of the reservoir necessitating removal of the reservoir and leaving the gastric band and tubing intraabdominal.At presentation, the patients' pain was not related to movement, respiration, or oral intake. Her weight loss was 18 kg in the last year despite removal of the reservoir. She also complained of pyrosis. Physical examination showed a cicatrical hernia in the left upper quadrant. There were no further abnormalities. Her BMI was 33.9. Laboratory test showed a BSE of 71 mm/h, white cell count of 7.0×10 9 /L, and CRP of 12 mg/L.

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Migration of adjustable gastric banding from a cohort study of 4236 patients

Abstract: The risk of an intragastric band migration remains low in the literature but could grow on account of the longer follow-up of patients. The retrieval of the band is the gold standard and must be planned promptly or delayed according to symptoms.

Cited by 91 publications

References 24 publications

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

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

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

A Rare Complication After Laparoscopic Gastric Banding: Connecting-Tube Penetration into the Hilus of the Kidney

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