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Zentralbl Chir 2005; 130(5): 410-418
DOI: 10.1055/s-2005-836873
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© Georg Thieme Verlag Stuttgart · New York

Langzeitergebnisse nach Gastric Banding

Long-Term Results After Gastric BandingC. Stroh1 , U. Hohmann1 , H. Schramm1 , T. Manger1
  • 1Departement für Allgemein- und Viszeralchirurgie, SRH Wald-Klinikum Gera gGmbH, Akademisches Lehrkrankenhaus der Friedrich-Schiller-Universität Jena
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Publication History

Publication Date:
11 October 2005 (online)

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Zusammenfassung

Hintergrund: Das Gastric Banding ist eine weit verbreitete bariatrische Operation in Europa. Die Häufigkeit von Langzeitkomplikationen wie Pouchdilatation, Slippage und Bandmigration und der Langzeiteffekt der Gewichtsreduktion sind in Metaanalysen und wenigen Langzeitbeobachtungen untersucht. Wir berichten über unsere Erfahrungen mit dem Gastric Banding. Methoden: In 10 Jahren wurde bei 168 Patienten eine Gastric Banding-Operation durchgeführt. Präoperative Daten, der postoperative Gewichtsverlust und Langzeitkomplikationen wurden prospektiv erfasst und retrospektiv analysiert. Ergebnisse: Das Durchschnittsalter der Patienten war 41,7 Jahre mit einem mittleren BMI von 49,6 kg/m². In den ersten 30 Tagen postoperativ traten keine Todesfälle auf. Die Konversionsrate betrug 7,1 %. 79,8 % der Patienten (n = 134) unterzogen sich einem regelmäßigem Follow-up (mittlere Nachbeobachtungszeit 66,7 Monate). Postoperative Langzeitkomplikationen traten bei 22,5 % der Patienten auf. 30 Komplikationen (17,8 %) waren Band-abhängige Komplikationen und 8 (4,7 %) waren Komplikationen von Seiten des Portsystems. Der mittlere Übergewichtsverlust betrug 39,6; 47,3; 44,2; 43,4 und 32 % nach 1, 2, 4, 5, und 8 Jahren. Fazit: Durch das Gastric Banding kann ein effektiver Gewichtsverlust erzielt werden. Jedoch beeinflussen Band-abhängige Komplikationen und funktionelle Aspekte die Langzeitergebnisse. Richtlinien zur Wahl der geeigneten bariatrischen Methode sind notwendig, um die Therapieversager und die Komplikationsrate zu reduzieren.

Abstract

Background: Adjustable gastric banding is a popular bariatric operation in Europe. The rate of long-term complications like pouch dilatation, slippage and band migration and the long-term effect of weight loss are reported in meta-analysis and few studies for a period of more than five years. We report on experiences after gastric banding. Methods: Over a period of 10 years 168 patients with morbid obesity were treated with gastric banding. Preoperative data, postoperative weight loss and long-term complications were prospectively obtained and retrospectively analyzed. Results: Mean age of the patients was 41.7 years with a mean preoperative BMI of 49.6 kg/m². No intraoperative or postoperative death occurred in the first 30 postoperative days. Intraoperative conversion rate was 7.1 %. 79.8 % of the patients (n = 134) were available for follow up (mean follow-up time 66.7 months). Long-term complications occurred in 22.5 % of the patients. 30 complications (17.8 %) were related to the band and 8 (4.7 %) to the access-port or to the tube. Mean excess weight loss was 39.6, 47.3, 44.2, 43.4 and 32 % after 1, 2, 4, 5 and 8 years. Conclusions: Laparoscopic gastric banding can achieve an effective weight loss. However band-related and functional complications will influence the late outcome. Pathways to choose the best surgical method for the individual patient are necessary to reduce failures after gastric banding.

Schlüsselwörter

morbide Adipositas - bariatrische Chirurgie - Gastric Banding - Slippage - Pouchdilatation - Bandmigration

Key words

morbid obesity - bariatric surgery - gastric banding - slippage - pouch dilatation - band migration

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Dr. Christine Stroh

Departement für Allgemein- und Viszeralchirurgie · SRH Wald-Klinikum Gera gGmbH

Straße des Friedens 122

07548 Gera

Phone: 03 65/8 28 31 01

Fax: 03 65/8 28 31 02

Email: Christine.Stroh@wkg.srh.de