Disappointing Gastric Banding Results Seen After 10 Years

Posted Oct 16, 2008.By Jeff Evans

NATIONAL HARBOR, Md. (EGMN) - Treatment failure with laparoscopic adjustable gastric banding occurred in nearly half of all patients who received the procedure during 10 years of follow-up, according to a review of a consecutive series of patients at one center.

Dr. Philippe Mognol reported that 374 (44%) of 841 patients who underwent the procedure during 1995-2005 failed the treatment. These failures included 124 patients who lost less than 25% of their excess weight and 250 patients who had their band removed (134 with removal alone, 115 with conversion to gastric bypass, 1 with conversion to sleeve gastrectomy).

More patients would have failed treatment if the investigators had defined treatment failure with the more conservative and conventional cut-off of less than 50% excess weight.

There was a similar rate of failure and band removal for both perigastric and pars flaccida surgical approaches, said Dr. Mognol of Bichat-Claude Bernard Hospital, Paris.

The same team performed all surgeries. The patients were mostly women with an average age of 40 years and an average body mass index of 46 kg/m². Follow-up data were available for about 90% of the patients at 8 and 10 years after surgery, Dr. Mognol said at the annual meeting of the American Society for Metabolic and Bariatric Surgery.

Among patients who had a band in place, the mean percentage of excess weight loss reached a plateau at 2 years at 44% with a mean BMI of 37 kg/m². At the end of 10 years of follow-up, 577 patients who still had a gastric band in place had lost a mean of only 22% of their excess weight. Excess weight loss reached at least 25% in 453 patients who still had their band in place.

Morbidity occurred early in 1% of patients and late in 19%. Another 9% of patients developed port-related morbidity. Only one patient in the series died.