72 - Freie Mitteilung
Bariatry & hernia I
16. Mai 2019, 17:30 - 19:00, Bellavista 3+4, 6. OG
Long-term outcomes and frequency of revisional bariatric surgeries 15 years and beyond after gastric banding: A high band failure rate with safe revisions
C. Tsai, J. Zehetner, J. Beel, R. Steffen, Presenter: C. Tsai (Bern)
Surgical treatment of morbid obesity has changed over time, with laparoscopic adjustable gastric band (LAGB) having encouraging early results. We present our outcomes beyond 15 years’ follow-up after LAGB.
This is a retrospective review of patients receiving LAGB between 1997-2002 with minimum 15 years’ follow-up at our bariatric surgery center in Berne, Switzerland. A comparative group of primary Roux-en-Y gastric bypass (RYGB) patients were identified. Patient characteristics, comorbidities, re-operative bariatric surgery (RBS), and weight trends were analyzed.
A total of 387 patients with LAGB were identified, of them 342 (88.4%) had a minimum of 15 years’ (R15-21) follow-up. There were 270 (78.9%) females with mean age 40.3 years (R15-62) and BMI 43.1 kg/m2 (R30.0-60.1), and 72 (21.1%) males with mean age 41.2 years (R16-61) and BMI 43.6 kg/m2 (R33.0-72.5). During follow-up, 283 (82.7%) patients underwent a mean of 3.3 RBS (R1-5), with 224 (65.5%) converted to RYGB. At the end of the study period, 96 (28%) patients still had a band in place. Wed identified 30 primary RYGB patients during the same time period with minimum 15 years’ follow-up. Comparing RYGB after LAGB to primary RYGB, there were no increases in 30-day bleeding, infection, nor leak rates. No deaths were recorded. At most recent follow-up after LAGB, mean excess BMI loss was 65.4% (R -9.4-134.5) with significant decrease in comorbidities.
Only 28% of patients had sufficient weight loss outcomes after LAGB alone and predictive selection criteria are lacking. The majority of LAGB surgeries fail even with close structured follow-up. RBS can be done safely.