Complications after Laparoscopic Adjustable Gastric Banding for Morbid Obesity: Experience with 1,000 Patients over 7 Years (original) (raw)

Background: Laparoscopic adjustable gastric banding (LAGB) is considered the least invasive surgical option for morbid obesity. It is less efficient than gastric bypass in weight loss, but has the advantage of being potentially reversible and can improve the quality of life if mortality and morbidity are low. Methods: Between 1996 and 2003, 1,000 patients underwent LAGB. There were 896 women and 104 men with mean age 40.4 years (16.3-66.3). Preoperative mean BMI was 44.3 kg/m2. Results: There were no deaths. Cumulative rate of complications was 192 (19.2%). 12 were life-threatening (1.2%): gastric perforation (n=4), acute respiratory distress (n=2), pulmonary embolism (n=2), migration (n=3), and gastric necrosis (n=1). 111 patients required an abdominal reoperation (11.1%) for perforation (n=2), slippage (n=78), migration (n=3), necrosis (n=1), esophageal dilatation (n=2), incisional hernias (n=4) and port problems (n=21). Before October 2000, we used the perigastric technique, and the slippage rate was 24% (91 / 378 ).Then, we changed to the pars flaccida approach and the slippage rate fell to 2% (13 / 622). The pars flaccida approach demonstrated safety in relation to both risks of perforation and slippage. Conclusion: The cumulative complication rate increased to 3-4 years, and then decreased with experience and technical improvement. Concerns of long-term follow-up should be migration and esophageal dilatation, which seem to be rare at 3 years.

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Authors and Affiliations

1. Departments of Digestive Surgery and Nutrition, Hopital Européen Georges Pompidou, Paris, France
   Jean-Marc Chevallier MD, PhD
2. Departments of Digestive Surgery and Nutrition, Hopital Européen Georges Pompidou, Paris, France
   Franck Zinzindohoué MD
3. Departments of Digestive Surgery and Nutrition, Hopital Européen Georges Pompidou, Paris, France
   Richard Douard MD
4. Departments of Digestive Surgery and Nutrition, Hopital Européen Georges Pompidou, Paris, France
   Jean-Philippe Blanche MD
5. Departments of Digestive Surgery and Nutrition, Hopital Européen Georges Pompidou, Paris, France
   Jean-Louis Berta MD
6. Departments of Digestive Surgery and Nutrition, Hopital Européen Georges Pompidou, Paris, France
   Jean-Jacques Altman MD, PhD
7. Departments of Digestive Surgery and Nutrition, Hopital Européen Georges Pompidou, Paris, France
   Paul-Henri Cugnenc MD

Authors

1. Jean-Marc Chevallier MD, PhD
2. Franck Zinzindohoué MD
3. Richard Douard MD
4. Jean-Philippe Blanche MD
5. Jean-Louis Berta MD
6. Jean-Jacques Altman MD, PhD
7. Paul-Henri Cugnenc MD

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Chevallier, JM., Zinzindohoué, F., Douard, R. et al. Complications after Laparoscopic Adjustable Gastric Banding for Morbid Obesity: Experience with 1,000 Patients over 7 Years.OBES SURG 14, 407–414 (2004). https://doi.org/10.1381/096089204322917954

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• Published: 01 March 2004
• Issue date: March 2004
• DOI: https://doi.org/10.1381/096089204322917954