Should Adjustable Gastric Bands Be Done Only in Specialized Banding Centers?

Ashutosh Kaul, MD FRCS FACS, Thomas Sullivan, BS, Pawandeep Hunjan, MD, Anthony Maffei, MD FACS, Thomas Cerabona, MD FACS. New York Medical College


Adjustable gastric bands outcomes for weight loss have shown wide variations with some specialized centers showing excellent weight loss while others have shown poor outcomes in comparison to other weight loss procedures.

The aim of this presentation was to compare the results of three commonly performed bariatric surgery procedures in a center of excellence fellowship training academic hospital. This is a retrospective analysis of prospectively maintained data from April 2008 till April 2011. All cases were done by four bariatric surgeons and by fellowship trainees under their guidance.
During this period 874 bariatric surgery cases were done. 382 cases were laparoscopic roux-en-Y gastric Bypass (LRYGB) , 270 were adjustable gastric banding (AGB) and 207 were laparoscopic sleeve gastrectomies (LSG) while the rest were Revisional cases and were excluded from further analysis. All cases were completed laparoscopically. The preoperative BMI were comparable (LRYGB = 46.1 kg/m2, AGB= 42.7 kg/m2, LSG =47.8 kg/m2). Weight loss after surgery showed significant dichotomy in our series with AGB showing significantly poorer results compared to both LRYGB and LSG at 6 months, 1 year and 2 year follow up in our series. The mean % weight loss in different procedures at 6 months was LRYGB = 53.4%, AGB= 27.3%, LSG =46.7%, at one year was LRYGB = 73%, AGB= 30.9%, LSG =61.9%, and at 2 years was LRYGB = 73.8%, AGB= 36.8%, LSG =64.2%.
Our results seem to suggest that in our hands LSG and LRYGB have better weight loss results compared to patients undergoing AGB. Specialized centers doing mainly AGB have presented great results while centers doing smaller percentage of AGB in comparison have shown poorer results. This may suggest that AGB results may be better in specialized centers doing mainly bands. Factors which may play a role will be discussed.


Session Number: Poster – Poster Presentations
Program Number: P469
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