Niculae Iordache, Saleh Abujamra, Anamaria Nedelcu, Octav Ginghina, Razvan Andrei Stoica, Ramon Vilallonga, Marius Nedelcu
{"title":"15年后胃束带:迁移率和处理。","authors":"Niculae Iordache, Saleh Abujamra, Anamaria Nedelcu, Octav Ginghina, Razvan Andrei Stoica, Ramon Vilallonga, Marius Nedelcu","doi":"10.1177/10926429251384810","DOIUrl":null,"url":null,"abstract":"<p><p><b><i>Background:</i></b> Laparoscopic adjustable gastric banding (LAGB) was once a widely adopted bariatric procedure due to its reversibility and minimally invasive nature. However, concerns about long-term complications, particularly intragastric migration and slippage, have led to a decline in its use. <b><i>Methods:</i></b> We conducted a retrospective review of 411 patients who underwent LAGB between 2002 and 2010 at a tertiary care center. Data on demographics, complication rates, time to onset, and management strategies were analyzed. Follow-up data were available for 178 patients over a 15-year period. <b><i>Results:</i></b> Band migration was diagnosed in 33 patients (18.5%), with a median detection time of 74 months post-implantation. Most cases (54.5%) were diagnosed between 6 and 10 years postoperatively. Common clinical presentations included weight regain (45.4%) and port-site infection with fever (33.3%), while 21.2% were asymptomatic. Surgical removal was performed in all migration cases, with a laparoscopic approach successfully used in 84.8%. Conversion to open surgery was necessary in 2 patients, and primary laparotomy was used in 3 early cases. Band slippage occurred in 10.7% of patients, with 63.2% requiring surgical intervention. Postoperative complications were minimal and managed conservatively. <b><i>Conclusions:</i></b> Our findings confirm that LAGB is associated with a significant long-term risk of complications, particularly band migration, which may occur more than a decade postoperatively. Long-term follow-up is essential, and routine upper GI imaging should be considered in all patients with LAGB, especially in those presenting with port-site infections. These results highlight the importance of individualized management and long-term vigilance in patients undergoing LAGB.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1000,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Gastric Band after 15 Years: Migration Rates and Management.\",\"authors\":\"Niculae Iordache, Saleh Abujamra, Anamaria Nedelcu, Octav Ginghina, Razvan Andrei Stoica, Ramon Vilallonga, Marius Nedelcu\",\"doi\":\"10.1177/10926429251384810\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b><i>Background:</i></b> Laparoscopic adjustable gastric banding (LAGB) was once a widely adopted bariatric procedure due to its reversibility and minimally invasive nature. However, concerns about long-term complications, particularly intragastric migration and slippage, have led to a decline in its use. <b><i>Methods:</i></b> We conducted a retrospective review of 411 patients who underwent LAGB between 2002 and 2010 at a tertiary care center. Data on demographics, complication rates, time to onset, and management strategies were analyzed. Follow-up data were available for 178 patients over a 15-year period. <b><i>Results:</i></b> Band migration was diagnosed in 33 patients (18.5%), with a median detection time of 74 months post-implantation. Most cases (54.5%) were diagnosed between 6 and 10 years postoperatively. Common clinical presentations included weight regain (45.4%) and port-site infection with fever (33.3%), while 21.2% were asymptomatic. Surgical removal was performed in all migration cases, with a laparoscopic approach successfully used in 84.8%. Conversion to open surgery was necessary in 2 patients, and primary laparotomy was used in 3 early cases. Band slippage occurred in 10.7% of patients, with 63.2% requiring surgical intervention. Postoperative complications were minimal and managed conservatively. <b><i>Conclusions:</i></b> Our findings confirm that LAGB is associated with a significant long-term risk of complications, particularly band migration, which may occur more than a decade postoperatively. Long-term follow-up is essential, and routine upper GI imaging should be considered in all patients with LAGB, especially in those presenting with port-site infections. These results highlight the importance of individualized management and long-term vigilance in patients undergoing LAGB.</p>\",\"PeriodicalId\":50166,\"journal\":{\"name\":\"Journal of Laparoendoscopic & Advanced Surgical Techniques\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2025-09-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Laparoendoscopic & Advanced Surgical Techniques\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/10926429251384810\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Laparoendoscopic & Advanced Surgical Techniques","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/10926429251384810","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
Gastric Band after 15 Years: Migration Rates and Management.
Background: Laparoscopic adjustable gastric banding (LAGB) was once a widely adopted bariatric procedure due to its reversibility and minimally invasive nature. However, concerns about long-term complications, particularly intragastric migration and slippage, have led to a decline in its use. Methods: We conducted a retrospective review of 411 patients who underwent LAGB between 2002 and 2010 at a tertiary care center. Data on demographics, complication rates, time to onset, and management strategies were analyzed. Follow-up data were available for 178 patients over a 15-year period. Results: Band migration was diagnosed in 33 patients (18.5%), with a median detection time of 74 months post-implantation. Most cases (54.5%) were diagnosed between 6 and 10 years postoperatively. Common clinical presentations included weight regain (45.4%) and port-site infection with fever (33.3%), while 21.2% were asymptomatic. Surgical removal was performed in all migration cases, with a laparoscopic approach successfully used in 84.8%. Conversion to open surgery was necessary in 2 patients, and primary laparotomy was used in 3 early cases. Band slippage occurred in 10.7% of patients, with 63.2% requiring surgical intervention. Postoperative complications were minimal and managed conservatively. Conclusions: Our findings confirm that LAGB is associated with a significant long-term risk of complications, particularly band migration, which may occur more than a decade postoperatively. Long-term follow-up is essential, and routine upper GI imaging should be considered in all patients with LAGB, especially in those presenting with port-site infections. These results highlight the importance of individualized management and long-term vigilance in patients undergoing LAGB.
期刊介绍:
Journal of Laparoendoscopic & Advanced Surgical Techniques (JLAST) is the leading international peer-reviewed journal for practicing surgeons who want to keep up with the latest thinking and advanced surgical technologies in laparoscopy, endoscopy, NOTES, and robotics. The Journal is ideally suited to surgeons who are early adopters of new technology and techniques. Recognizing that many new technologies and techniques have significant overlap with several surgical specialties, JLAST is the first journal to focus on these topics both in general and pediatric surgery, and includes other surgical subspecialties such as: urology, gynecologic surgery, thoracic surgery, and more.