Eroded Gastric Band: Where to Next? An Analysis of the Largest Contemporary Series
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ORIGINAL CONTRIBUTIONS
Eroded Gastric Band: Where to Next? An Analysis of the Largest Contemporary Series Savio G. Barreto 1,2 & Jacob Chisholm 1,3 & Anne-Sophie Mehdorn 4 & Jane Collins 3 & Ann Schloithe 2 & Lilian Kow 1,2,3
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose Erosion of a laparoscopic adjustable gastric band (LAGB) is a devastating problem. There is no clear evidence in literature to guide the choice of revisional procedure following an eroded LAGB. The purpose of this study is to analyse the largest series of erosions following LAGB published to-date with an aim to share our experience with this rare complication and how we managed this cohort of patients following explantation of their LAGB. Materials and Methods This is a retrospective cohort study. Patient data is maintained prospectively in a surgical database. The study period was from January 1996 to January 2019. The outcomes of patients who underwent an erosion of LAGB were studied. Results Gastric band erosion was encountered in 4.7% of patients. Sixty patients opted for a revisional procedure which included 37 repeat LAGBs, 6 laparoscopic sleeve gastrectomies (LSG), 7 Roux-en-Y gastric bypasses (RYGB), 1 intragastric balloon, and 9 failed revisional procedures. Re-erosions were noted in 27% of patients who underwent a repeat gastric banding. Median %TWL at a 1-year follow-up was significantly higher in LSG and RYGB groups compared with that in LAGB (P < 0.008 and P < 0.000, respectively). There was no significant difference between the LSG and RYGB groups. Conclusion The risk of re-erosion is increased in patients who undergo repeat AGB following a previous episode of erosion. Repeat LAGB should not be offered after a previous erosion. LSG and RYGB should be considered as appropriate revisional procedures in a patient who experience weight regain following explantation of an eroded LAGB. Keywords Adjustable gastric banding . Band erosion . Conversion . Revisional surgery . Slippage . Weight regain
Introduction The laparoscopic adjustable gastric band (LAGB) was introduced in 1994 [1–3] bringing with it the promise of a Savio G. Barreto and Jacob Chisholm contributed equally to this work. * Lilian Kow [email protected] 1
Hepatobiliary and Oesophagogastric Unit, Division of Surgery and Perioperative Medicine, Flinders Medical Centre, Bedford Park, Adelaide, South Australia, Australia
2
College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
3
Adelaide Bariatric Centre, Flinders Private Hospital, Bedford Park, Adelaide, South Australia, Australia
4
Department of General, Visceral, Thoracic, Transplantation and Pediatric Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
reversible bariatric operation along with good long-term weight loss [4] and an improvement in excess body fat related co-morbidities [5]. The rise in popularity of the operation in the ensuing years and the significant reduction in the number of these pr
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