Results of the Italian multicenter study on 239 super-obese patients treated by adjustable gastric banding

Background: Laparoscopic adjustable gastric banding (LAGB) is the most common bariatric operation. This study is a retrospective analysis of the multicenter Italian experience in patients with BMI >50 over the last 4 years. Methods: An electronic data sheet made for LAGB-operated patients since January 1996, was mailed and e-mailed to all surgeons involved in this kind of procedure in Italy. Items regarding patients with BMI >50 were selected. Analysis used Fisher's exact test and logarithmic regression analysis (P<0.05 significant). Data were expressed as mean +/- SD. Results: 239 patients (13.3%), out of 1,797 LapBand(R) operated patients entered the study (179F/60M), with mean age 37.6 +/- 11.3 years (19-69) and mean BMI 54.6 +/- 4.8 (50.1-83.6). Laparotomic conversion rate was 5.4% (44/239). Postoperative complications occurred in 24/239 patients (9.0%). Follow-up was obtained in 218/218, 198/198, 121/147, 75/93, 30/38 LAGB patients at 6,12, 24, 36, and 48 months respectively. At these time periods, mean BMI was 46.7, 43.9, 42.2, 41.9, and 39.3 kg/m(2). At the same intervals, mean %EWL was 24.1, 34.1, 38.8, 38.9, and 52.9%. The number of patients with <25% EWL at 12, 24,36, and 48 months follow-up were 34,10,4, and 0. Serious co-morbidities (189 in 124 of 239, 57%) had completely resolved 1 year postoperatively in 74 124 of the patients (59.6%). Conclusion: Although super-obese patients following the LAGB remain obese with BMI>35, in the short-term most lose their co-morbidities, with a very low morbidity and mortality rate.