Snakeskin Appearance of Gastric Mucosa Compressed by Adjustable Gastric Bands: A Novel Diagnostic Marker of Band Migration

ABSTRACT

PURPOSE: The aim of this retrospective study is to describe changes of gastric mucosa in patients with adjustable gastric band migration, and to evaluate the diagnostic value of these changes.MATERIALS AND METHODS: The postoperative endoscopies of all patients that underwent adjustable gastric band surgery at a single tertiary center were retrospectively reviewed. Gastric mucosal patterns were classified based on the appearance of gastric mucosae compressed by adjustable gastric bands, as follows; Group A: normal appearance, Group B: snakeskin (reticular) appearance without band migration, Group C: snakeskin appearance with band migration, and Group D: recuperated gastric mucosa with advanced band migration.RESULTS: Postoperative endoscopic findings of 109 patients obtained from Jan 2012 to Oct 2018 were available, and these patients were assigned to the four groups, as follows; 82 to group A, 5 to group B, 14 to group C, and 8 to group D. Times (months) between AGB implantation and initial postoperative endoscopy evaluations were 45.2±22.3, 40.0±28.2, 36.2±18.6, and 42.1±17.0, respectively (P=0.531). Of the five patients in Group B, 3 underwent band explantation due to band migration (P=0.000).CONCLUSION: Conclusion A snakeskin pattern of gastric mucosa compressed by adjustable gastric band is strongly associated with adjustable band migration. The presence of this pattern might predict band migration before endoscopic confirmation and its identification might prevent complications associated with long-standing band migration.