AI Article Synopsis
- The study focused on the complications of laparoscopic adjustable gastric banding, particularly intragastric erosion, and the outcomes of endoscopic band removal over five years at multiple centers in Brazil.
- A total of 82 patients with band erosion were analyzed, revealing an average BMI drop from 43.2 kg/m² pre-surgery to 31.8 kg/m² at erosion diagnosis, with symptoms like pain and infection reported in some cases.
- The endoscopic procedure was successful in 95% of cases, with most bands removed in one session, indicating that endoscopic removal is a safe and effective primary option for managing this complication.
Article Abstract
Background: One of the complications of laparoscopic adjustable gastric banding is intragastric erosion, leading to a revisional procedure to remove the band. Our aim was to present the procedure and results of endoscopic band removal in a 5-year multicenter experience from the Gastro Obeso Center and Universidade de São Paulo, São Paulo, and Universidade Federal de Pernambuco, Recife, Brazil.
Methods: From 2003 to 2008, 82 patients were diagnosed with band erosion. The clinical data concerning the endoscopic procedure were prospectively recorded and retrospectively reviewed.
Results: The average preoperative body mass index was 43.2 kg/m(2) (range 34-50). At the diagnosis of intragastric erosion, the body mass index was 24-41 kg/m(2) (average 31.8). The erosion occurred an average of 16.3 months (range 6-36) postoperatively. The symptoms included pain in 25 (31%), port infection in 21 patients (27%), and weight regain in 20 (25%), and 12 patients (15%) were asymptomatic. Endoscopic removal was possible for 78 patients (95%). In 85% of patients, the band was removed in the first session, with an average duration of 55 minutes (range 25-150). Five cases of pneumoperitoneum occurred after the procedure. Of these, 3 were treated conservatively, 1 was treated by laparoscopy, and 1 was treated by abdominal puncture using the Veress needle.
Conclusion: Endoscopic removal of eroded laparoscopic adjustable gastric banding is safe and effective. It can be used as a first choice procedure in clinical practice.
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| http://dx.doi.org/10.1016/j.soard.2009.09.016 | DOI Listing |
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