Laparoscopic vertical banded gastroplasty versus laparoscopic adjustable gastric banding in morbidlty obese patients: a comparative study

ABSTRACT

To compare between laparoscopic vertical banded gastroplasty and laparoscopic adjustable gastric banding as regard the operative procedure, efficiency, clinical results and complications, in the treatment of morbid obesity A total of 40 morbidly obese patients, with body mass index [BMl] 40 to 50 kg/m[2] were selected to either laparoscopic adjustable silicone banding [LASGB] [n = 21 cases] or laparoscopic vertical banding gastroplasty [LVBG] [n 19 cases]. The patients were operated upon during the period between February 2000 to November 2001 with a follow up period of 24 months postoperatively There were no deaths in both groups but conversions to open surgery in one case in [LVBG]. Mean operative time was 94.2 minutes in [LVBG] versus 65.4 minutes in [LASGB] [P < 0.05] Early morbidity rate was lower in LASGB [6.1%] versus LVBG [9.8%]. Mean hospital stay was shorter in LASGB [3 days] versus LVBG [6 days [P < 0.05,]. Late complications in LVBG was 14% and in LASGB was 32.7% [P < 0.05]. The most frequent complication was slippage of the band [18%]. Late reoperations rate in LVBG was 0% versus 24.5% in LASGB [P < 0.001]. Weight loss in LVBG after 2 years was [63.5%], versus 41.4% in LASGB. BMI in L VBG at 2 years was 29.7 kg/m[2] versus 34.8kg/m[2] in LASGB. This study demonstrates that, in patients with BMI 40 to 50 kg/m[2], LASGB requires shorter operative time and hospital stay but LVGB is more effective in terms of late complications reoperations and weight loss