Adjustable laparoscopic gastric banding in patients with morbid obesity: radiographic management, results, and postoperative complications

PURPOSE: To determine the role of radiographic assessment in patients who u nder:went an adjustable laparoscopic gastric banding (ALCB) for the treatme nt of morbid obesity and to evaluate the frequency and type of postoperativ e complications. MATERIALS AND METHODS: From September 1995 to March 1998, 98 consecutive pa tients (18 men, 80 women; mean age, 39 years; age range, 22-62 years) with morbid obesity (mean body weight 132 kg; mean body mass index, 47.1 kg/m(2) ) underwent ALGB. In all patients, fluoroscopy was performed postoperativel y to confirm band position and to exclude perforation and at 6-8 weeks late r to measure and adjust the stoma between the pouch and stomach for optimal weight loss. All patients underwent another examination 12 months postoper atively, whereas patients with unsatisfactory weight loss or patients suspe cted of having complications were examined earlier and on several occasions . RESULTS: Port puncture was feasible in all cases, and stomal adjustments co uld easily be repeated. Absolute (ie, total) weight loss after 1 year range d from 8.8% to 39.2% (mean, 18.3%). Twenty patients showed unsatisfactory w eight loss. No early complications occurred. Fate complications occurred in 34 patients and included,product 1 dilatation (concentric or eccentric wit h posterior slippage), eccentric band herniation, band penetration, disconn ection, axial pouch herniation, and port-site infection. CONCLUSION: ALCB is an effective method in the treatment of morbid obesity. Radiographic assessments are crucial in the management of weight loss and detection postoperative complications.