Early experience with diagnosis and management of eroded gastric bands.
10.4174/jkss.2012.82.1.18
- Author:
Chang Ik YOON
1
;
Kyung Ho PAK
;
Seong Min KIM
Author Information
1. Department of Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea.
- Publication Type:Original Article
- Keywords:
Gastric banding;
Bariatric surgery;
Band erosion;
Morbid obesity;
Complications
- MeSH:
Abdominal Abscess;
Abdominal Pain;
Bariatric Surgery;
Body Mass Index;
Catheters;
Cytochrome P-450 CYP1A1;
Drainage;
Female;
Humans;
Laparoscopy;
Male;
Obesity;
Obesity, Morbid;
Peritonitis;
Postoperative Complications;
Retrospective Studies;
Sepsis
- From:Journal of the Korean Surgical Society
2012;82(1):18-27
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Band erosion is a well-known complication of laparoscopic adjustable gastric band placement. We gained experience with laparoscopic removal of an eroded gastric band. METHODS: We retrospectively reviewed the operative log of our obesity surgery unit to identify all operations performed for band erosion from March 2009 to May 2011. RESULTS: During the study period, a total of six of 96 patients (6.3%), five females and one male, were diagnosed with band erosion and underwent surgical removal of the band system. The median time interval from the initial gastric band placement to the diagnosis of band erosion was 8.5 months (range, 7 to 22 months), with most band erosion occurring within the first year (5/6, 83%). The median body mass index at band removal was 28.4 kg/m2. Upper abdominal pain was the most common symptom (5/6, 83%), and other signs and symptoms were port site infection (3/6, 50%) and loss of restriction and weight regain (1/6, 17%). All eroded bands were removed using laparoscopy. Further complications after laparoscopic removal of the band system were observed in three cases. One patient showed multiple intra-abdominal abscesses requiring insertion of a pigtail catheter for drainage. The other two patients experienced sepsis with localized peritonitis, eventually requiring laparoscopic washout and drainage. CONCLUSION: Gastric band erosion requires the removal of the gastric band. Laparoscopic removal is technically achievable in the majority of patients with eroded gastric band. The method can be challenging, has potential postoperative complications (fistula, abscess), and should be attempted only by experienced surgeons.
