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Systematic Review of Erosion after Laparoscopic Adjustable Gastric Banding

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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.

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Disclosures

The Centre for Obesity Research and Education receives an unrestricted grant from Allergan, the manufacturer of the Lap-Band™. They also receive educational funding from Applied Medical.

The author Wendy Brown received an honorarium from Allergan, the manufacturer of the Lap-Band™, for attending a scientific advisory panel in London in 2009.

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Authors and Affiliations

  1. Centre for Obesity Research and Education (CORE), The Alfred Centre, Monash University Melbourne, Commercial Rd, Melbourne, 3004, Australia

    Kristine Egberts, Wendy A. Brown & Paul E. O’Brien

  2. Monash University Department of Surgery, The Alfred Hospital, Melbourne, Australia

    Wendy A. Brown

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  1. Kristine Egberts
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  2. Wendy A. Brown
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  3. Paul E. O’Brien
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Correspondence to Kristine Egberts.

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Egberts, K., Brown, W.A. & O’Brien, P.E. Systematic Review of Erosion after Laparoscopic Adjustable Gastric Banding. OBES SURG 21, 1272–1279 (2011). https://doi.org/10.1007/s11695-011-0430-1

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