SAN DIEGO – Thirteen percent of patients who underwent laparoscopic adjustable gastric banding required a major reoperation, results from a long-term single-center study showed.
“We see complications, even many years after surgery,” Dr. Vincenzo Bacci said at the annual meeting of the American Society for Bariatric Surgery. “[These patients need] lifelong management and surveillance.”
He and his associates studied the rate and causes of reoperation in 448 patients who underwent laparoscopic adjustable gastric banding in the surgery department at La Sapienza University in Rome, between 1996 and 2006. In 2002, the perigastric technique was replaced by the pars flaccida approach. Of the 448 patients, 83% were women and their average body mass index was 43 kg/m
Of the total, 59 patients (13%) required a major reoperation for band repositioning/removal or revision, and 29 patients (6%) required a minor reoperation for port complications. Patients with a BMI of greater than 50 kg/m
The main reasons for major reoperation were dilatation, erosion of the band, lack of weight loss, psychological problems, and slippage. Minor reoperations were necessitated by infections of the port site, a twist of the port, or breakage. The rate of major reoperation in a subset of patients followed for longer than 5 years was 24%, chiefly because they had undergone gastric banding with the perigastric technique.