Outcome and complications after laparoscopic Swedish adjustable gastric banding: 5-year results of a prospective clinical trial

Background: Bariatric surgery is currently the only effective treatment for morbid obesity in terms of inducing and maintaining satisfactory weight loss and decreasing weight-related co-morbidities. A study was conducted to assess the effects, complications and outcome after laparoscopic Swedish adjustable gastric banding (SAGB) to 5 years. Methods: Between June 1998 and December 2005, all patients with implantation of a SAGB were enrolled in a prospective clinical trial. Results were recorded and classified, with special regard to long-term complications and re-operation rate. Results: SAGB was performed in 128 patients (87 female, 41 male). Mean age was 40.2 +/- 5.3 years, with mean preoperative BMI 44.5 +/- 3.9 kg/m(2). Overall mortality was 0%. Patient follow-up was 94.5%. BMI after 1, 2 and 5 years was 35.7 +/- 3.7 kg/m(2) (P<0.005), 33.7 +/- 3.8 kg/m(2) (P<0.001) and 31.8 +/- 3.8 kg/m(2) (P<0.001), respectively. Mean EWL after 1, 2 and 5 years was 33.3 +/- 6.8% (P<0.005), 45.5 +/- 6.4% (P<0.001) and 57.4 +/- 6.5% (P<0.001), respectively. The non-responder rate (EWL<30%) after 2 and 5 years was 17.0% and 6.8%, respectively. The early complication rate (<30 d) was 6.25% (8/128), with 5 minor and 3 major complications. Late complications (>30 d) occurred in 10.9% (14/128), of whom 2 were minor and 12 were major complications. The overall re-operation rate was 11.7% (15/128). Conclusions: At 5-year follow-up, laparoscopic SAGB is a safe and effective surgical treatment for morbid obesity. Our results appear to confirm that SAGB is a safer surgical treatment regarding rate and severity of complications compared with gastric bypass and malabsorptive procedures.