Management of complications after laparoscopic adjustable gastric banding / 中华消化外科杂志

ABSTRACT

Objective To investigate the management of complications after laparoscopic adjustable gastric banding (LAGB).Methods The clinical data of 83 obese patients who were treated by LAGB at the Nankai Hospital from September 2005 to June 2011 were retrospectively analyzed.The complications after LAGB were analyzed.The adjustable gastric band was installed under laparoscope so as to form a small gastric pouch with a volume ranged between 20-30 ml.The water pump was fixed in the rectus abdominis anterior sheath under the appendix ensiformis.The gastric band was adjusted according to the changes of the body weight,symptoms after diet and results of imaging examination of upper gastrointestinal tract.Patients were followed up via out-patient examination and phone call till July 2013.Results The incidence of complications of the 83 patients was 44.6％ (37/83).Six patients had short-term complications and 31 patients had long-term complications.The short-term complication mainly presented as post-prandial vomiting.The symptoms of 5 patients were relieved by changing of eating habit.The condition of 1 patient was severe,and the symptom was relieved 5 days later after fasting and nutritional support.For the 31 patients with long-term complications,25 were complicated with band erosion into gastric lumen via gastric wall (6 patients were complicated with infection of the water pump site),and they were cured by removal of band laparoscopicly.Ten patients were complicated with water pump-related complications,including 6 with infection of the water pump site and 4 with pump migration.The water pumps of the 4 patients with pump migration were surgically removed.Two patients had band slipping to the stomach.The band was restored to the original place after removing the liquid from the band and reducing the food intake,and then the position of the band in 1 patient was restored to normal,and no change was observed in another patient,and the band was removed laparoscopicly.Conclusions The incidence of complications after LAGB is high,and it increases as the time passes by.Most of the long-term complications after LAGB need to be treated by reoperation.