The importance of patient selection in bariatric surgery: One not fit for all. Case report of a preventable double severe complication after Laparoscopic gastric banding positioning

Lucido, Francesco Saverio; Scognamiglio, Giuseppe; Salvucci, A.A.; Gambardella, Claudio; Brusciano, Luigi; Genio, Gianmattia del; Pizza, Francesco; Parmeggiani, Domenico; Parisi, Simona; Volpe, Mariachiara Lanza

doi:10.1016/j.ijscr.2020.09.003

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“…Regular outpatient visits are largely recommended in obese patients who underwent LAGB, making gradual and minimal increases in the quantity of the band filling until the optimal volume is reached [ 38 ]. This latter is determined by the patient’s subjective feeling of good hunger and satiety control without significant restrictive symptoms such as regurgitation, dysphagia, and reflux and minimal device inflation.…”

Section: Discussionmentioning

confidence: 99%

It is really time to retire laparoscopic gastric banding? Positive outcomes after long-term follow-up: the management is the key

Lucido

Scognamiglio²,

Nesta

et al. 2021

Updates Surg

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After the initial widespread diffusion, laparoscopic adjustable gastric banding (LAGB) has been progressively abandoned and laparoscopic sleeve gastrectomy (LSG) has become the worldwide most adopted procedure. Nevertheless, recent reports raised concerns about the long-term weight regain after different bariatric techniques. Considering the large LAGB series recorded in our multicentric bariatric database, we analysed the anthropometric and surgical outcomes of obese patients underwent LAGB at a long-term follow-up, focusing on LAGB management. Between January 2008 to January 2018, demographics, anthropometric and post-operative data of obese patients undergone LAGB were retrospectively evaluated. To compare the postoperative outcomes, the cohort was divided in two groups according to the quantity of band filling (QBF): low band filling group (Group 1) with at most 3 ml of QBF, and patients in the high band filling group (Group 2) with at least 4 ml. 699 obese patients were considered in the analysis (351 in Group 1 and 348 in Group 2). Patients in Group 1 resulted significantly associated (p < 0.05) to higher % EWL and quality of life score (BAROS Score), 49.1 ± 11.3 vs 38.2 ± 14.2 and 5.9 ± 1.8 vs 3.8 ± 2.5, respectively. Moreover, patients with lower band filling (Group 1) complained less episodes of vomiting, epigastric pain and post-prandial reflux and significantly decreased slippage and migration rate (p < 0.001 for all parameters). LAGB is a safe and reversible procedure, whose efficacy is primarily related to correct postoperative handling. Low band filling and strict follow-up seem the success’ key of this technique, which deserves full consideration among bariatric procedures.

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Section: Discussionmentioning

confidence: 99%

It is really time to retire laparoscopic gastric banding? Positive outcomes after long-term follow-up: the management is the key

Lucido

Scognamiglio²,

Nesta

et al. 2021

Updates Surg

Self Cite

View full text Add to dashboard Cite

show abstract

The importance of patient selection in bariatric surgery: One not fit for all. Case report of a preventable double severe complication after Laparoscopic gastric banding positioning

Abstract: Highlights LAGB presents many severe complications. Wedge resection could allow to preserve a tailored gastric pouch limiting postoperative nutritional defects. Strict postoperative follow-up reduce the risk of severe complications.

Cited by 1 publication

References 18 publications

It is really time to retire laparoscopic gastric banding? Positive outcomes after long-term follow-up: the management is the key

It is really time to retire laparoscopic gastric banding? Positive outcomes after long-term follow-up: the management is the key

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