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Silicone-adjustable gastric banding: disappointing results
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Radiology, Oncology and Radiation Science, Radiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Upper Abdominal Surgery.
1998 (English)In: Obesity Surgery, ISSN 0960-8923, E-ISSN 1708-0428, Vol. 8, no 4, 467-474 p.Article in journal (Refereed) Published
Abstract [en]

Background:

Silicone-adjustable Gastric banding (SAGB) has been popularized as a minimally invasive, completely reversible surgical treatment for morbid obesity. We report here out 3-year experience of SAGB with special reference to complications and side-effects.

Methods:

There were 90 patients in total, of whom 72 were women. Median age was 42 (range, 20-68) years and median body mass index (BMI) was 43 (range, 34-57) kg/m2. Laparoscopy was attempted to position the band in 63 cases but had to be converted to laparotomy in 16 (25%). Twenty-seven patients were laparotomized. We used the Swedish band (AB Obtech) throughout the series. In addition to regular clinic visits, patients were followed-up with upper gastrointestinal series 6 months postoperatively and gastroscopy after 2 years or earlier when symptomatic.

Results:

Median BMI decreased to 32 kg/m2 after 12 months and to 31 kg/m2 after 24 months. With a median follow-up time of 35 months (range, 22-48), 32 patients (35%) have been re-operated usually with removal of the balloon system and conversion into a Roux-en-Y gastric bypass. The most common reasons for re-operation were band erosion (n = 10) and erosive esophagitis (n = 14). Additional indications for re-operation included pouch dilatation, invagination of distal gastric wall through the band, leakage from the balloon, patient dissatisfaction, and severe allergic reaction. When questioned 2 years postoperatively more than half of the patients reported vomiting, heartburn and regurgitation but 78% still pronounced themselves satisfied with the operation. Esophagitis was found in 56% of the patients at gastroscopy after 2 years.

Conclusion:

SAGB could be positioned with laparoscopy in 75% of the cases but the incidence of complications and side-effects postoperatively has been high.

Place, publisher, year, edition, pages
1998. Vol. 8, no 4, 467-474 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-190186DOI: 10.1381/096089298765554386PubMedID: 9731684OAI: oai:DiVA.org:uu-190186DiVA: diva2:583099
Available from: 2013-01-07 Created: 2013-01-07 Last updated: 2017-12-06Bibliographically approved

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Öhrvall, MargaretaGustavsson, Sven

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