Systematic review of erosion after laparoscopic adjustable gastric banding

Obes Surg. 2011 Aug;21(8):1272-9. doi: 10.1007/s11695-011-0430-1.

Abstract

Erosion of the laparoscopic adjustable gastric band (LAGB) into the lumen of the stomach is a recognised complication of this procedure. We undertook a systematic literature review of the incidence, clinical features and management of erosions occurring after LAGB. A systematic search of relevant medical databases for full-text original articles looking for LAGB patients and reported erosions was conducted. We focussed on incidence, aetiology, clinical presentation, treatment, complications and weight loss. Twenty-five studies of LAGB reported 231 erosions in 15,775 patients (overall incidence of 1.46%). The mean number of patients per study was 631 (±486), and the mean follow-up was 3.73 (±2.4) years. In four reports involving less than 100 patients, there were 27 erosions in a total of 270 patients (10%) compared with 180 erosions in 12,978 patients (1.386%) in the remaining 21 reports. Multiple regression analysis showed that erosion rate was significantly predicted by number of patients and number of years of surgeon experience (r(2) = 0.186). Treatment was most commonly by removal of the band, repair of the stomach and later, band replacement. Other options were removal alone or conversion to another procedure. Weight loss was retained after treatment of the erosion with a mean weight loss at final follow-up of 50.34 ± 3.9 percent excess weight loss. Incidence of erosion after gastric banding is relatively low and can be related to surgeon experience. The most common treatment described in the literature is removal of the eroded band with delayed replacement. Replacement of the band is associated with maintenance of weight loss.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Device Removal
  • Foreign-Body Migration* / diagnosis
  • Foreign-Body Migration* / epidemiology
  • Foreign-Body Migration* / surgery
  • Gastroplasty / instrumentation*
  • Gastroplasty / methods
  • Humans
  • Laparoscopy
  • Obesity, Morbid / surgery*
  • Postoperative Complications* / diagnosis
  • Postoperative Complications* / epidemiology
  • Postoperative Complications* / surgery
  • Prostheses and Implants / adverse effects*
  • Regression Analysis
  • Reoperation
  • Silicones

Substances

  • Silicones