Poor Outcomes After Laparoscopic Adjustable Gastric Band

Background: Recent studies document EWL >50% for the laparoscopic adjustable gastric band (LAGB). This study reviews the LAGB experience at an urban academic center regarding complications, re-operative rate, and co-morbidities.

Methods: 146 consecutive patients undergoing LAGB from August 2005 to December 2007 were reviewed. Pre and postoperative data were collected including weight, BMI, EWL, co-morbidities, and complications. Multiple patient demographics were analyzed using a t-test.

Results: There were 139 women and 18 men with a mean weight of 127.2 kg ± 20.7 kg and BMI of 45.6 ± 6.2. The mean EWL was 20% ± 14% at 6 months (n=118), 26% ± 15% at 12 months (n=99), 27 %± 18% at 18 months (n=56), and 34% ± 24% at 24 months (n=37). Complications were seen in 6.2% (n=9) including port flipping, stoma obstruction, tube disconnection, port infections, and band slippage. Re-operation was required in 8 of these patients. Co-morbidities resolved in only 23% of patients. So far 4.8% (n=7) of patients required revision to sleeve gastrectomy for inadequate EWL. At 12 months, only 6 (6.1%) patients achieved >50% EWL. Also, >50% EWL was achieved in 1 (2.6%) patient over 45 years old and in 1 (2.1%) African-American patient. Overall, %EWL was significantly greater in Caucasians (p=0.022)

Conclusion: Following LAGB, a majority of patients failed to achieve a 50% EWL and 10.3% required re-operation. Our data shows that patients older than 45 years and African Americans may not benefit from LAGB.

Session: Poster

Program Number: P080

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