Long-term results of a prospective study on laparoscopic adjustable gastric banding for morbid obesity

Objective To study the long-term outcome of adjustable gastric banding in the treatment for morbid obesity. Summary background In Europe, the preference for the gastric band has declined in favor of the Roux-Y gastric bypass (RYGB). Methods Follow-up of a prospective study on a large cohort of patients after laparoscopic gastric banding (LAGB) for morbid obesity. Results Complete data were collected on 656 patients (88%) from a cohort of 745 patients. After a median follow-up of 95 months (range 60-155) the mean BMI dropped from 41.0 ± 7.3 kg/m2 to 33.2 ± 7.1 kg/m2, with a 46.2 ± 36.5% excess weight loss (EWL). A more than 50% EWL was achieved in 44% of patients. The band was still in place in 77.1% of patients, and conversion to gastric bypass after band removal was carried out in 98 (14.9%) patients, while a simple removal was done in only 52 (7.9%) patients. Band removal was more likely in women and patients with a higher BMI. Conclusions After LAGB, band removal was necessary for complications or insufficient weight loss in 24% of patients. Nearly half of the patients achieved a more than 50% EWL but in 88% a more than 10% EWL was observed. LAGB can achieve an acceptable weight loss in some patients, but the failure in one out of four patients does not allow to propose it as a first line option for the treatment of obesity