30% complications with adjustable gastric banding:: What did we do wrong?

Background: The authors analyzed the complications In patients following laparoscopic adjustable gastric banding (LAGB) for morbid obesity. Methods: Retrospective analysis of the 36 LAGB patients was done. The operations were performed from December 1997 to the December 1999 using the Lap-Band(R). Results: 11 complications occurred. Most common was port-site infection or port migration (5 patients). These complications were termed minor. In 3 patients, slippage of the gastric wall was observed, all corrected laparoscopically. In another 3 patients, removal of the band was necessary for poor patient compliance (1), for Intussusception of the gastric wall through the band with occlusion of the stoma (1), and for infection of the band (1). These complications were termed major. The overall complication rate was 30.5%. Conclusion: Compared to the literature, our complication rate was rather high. Based on our analysis, the following measures are recommended: 1) antibiotic prophylaxis; 2) drainage of the port-site; 3) proper band and port placement and fixation; 4) closer psychological evaluation and follow-up. By these measures, hopefully we can obtain better results in the future.