Abstract
ABSTRACT
Background
The long‐term clinical role of laparoscopic adjustable gastric banding (LAGB) remains uncertain in the contemporary era of metabolic surgery, and very long‐term outcome data from Asian populations are limited. This study evaluated very long‐term outcomes of LAGB in a Japanese cohort, focusing on weight change, metabolic comorbidities, and reoperations.
Methods
We retrospectively reviewed consecutive patients who underwent LAGB between 2005 and 2010 at a single institution. Changes in body weight, metabolic comorbidities, and reoperation were assessed for up to 15 years. Weight outcomes were evaluated using percent total weight loss (%TWL) and percent excess weight loss (%EWL).
Results
A total of 28 patients were included. Mean %EWL was 49% at 1 year, 62% at 5 years, 64% at 10 years, and 59% at 15 years, indicating sustained long‐term weight reduction despite partial weight regain. Early improvements in metabolic comorbidities were observed; however, recurrence of diabetes mellitus, hypertension, and dyslipidemia increased after 5–10 years, whereas hepatic comorbidities remained relatively stable. Reoperation was required in 7 of 28 patients (25%), mainly because of device‐related complications or insufficient weight loss.
Conclusion
This study provides very long‐term outcome data of LAGB in an Asian cohort. Although LAGB achieved sustained weight reduction in selected patients, metabolic improvements showed limited long‐term durability and a substantial proportion of patients required reoperation. These findings highlight the limitations of a purely restrictive and device‐dependent bariatric procedure in the contemporary era of metabolic surgery.