Laparoscopic adjustable gastric banding can help morbidly obese patients lose a significant amount of weight but "appears to result in relatively poor long-term outcomes," including band erosion and re-operation, according to an assessment of patients who had the procedure in Europe more than a decade ago.

Researchers from the European School of Laparoscopic Surgery in Brussels, Belgium, followed up with 82 patients who underwent gastric banding in the mid-1990s at a single university obesity center and found that they had a mean excess weight loss of 42.8%, according to the study results published in the Archives of Surgery. No patients had died because of the surgery, and about 60% said they were satisfied.

Despite their success with losing weight, 22% of patients had experienced minor complications from the surgery, and 38% had major complications, including 28% who experienced band erosion. Nearly half of the patients required additional surgery to have their bands removed, and 17% had their procedure switched to laparoscopic Roux-en-Y gastric bypass.

"Because nearly 1 out of 3 patients experienced band erosion, and nearly 50% of the patients required removal of their bands (contributing to a reoperation rate of 60%), LAGB appears to result in relatively poor long-term outcomes," conclude the researchers, led by Jacques Himpens, MD.

Allergan, the Calif.-based manufacturer of the Lap-Band gastric banding system, takes issue with several aspects of the European study. In an e-mailed response, Director of Corporate Communications Cathy Taylor notes that nearly half of the 151 patients contacted were "lost to follow up"; the patients were among the first to be treated with the procedure and therefore the surgeons were "at the bottom of their learning curve"; and the procedures involved "older band models" and "an inferior band implementation technique no longer used in clinical practice."

"This particular study in question contains various flaws and is contradictory to a preponderance of well-controlled clinical studies published in peer-reviewed literature today," says Ms. Taylor, citing other long-term assessments that have shown more positive long-term outcomes from LAGB.

The Food and Drug Administration recently expanded the patient population eligible to receive Lap-Band weight loss surgery to patients who have a body mass index between 30 and 40 and who have at least 1 co-morbidity.

Irene Tsikitas