P4. The Short Term Outcome of the First 10 Morbidly Obese Adolescent Patients in the FDA-Approved Trial for Laparoscopic Adjustable Gastric Banding

Objective. The aim of the study was to evaluate blood glucose, insulin resistance indices, and adipokine (leptin and adiponectin) levels in morbidly obese individuals with and without type 2 diabetes mellitus and to compare the changes in these parameters 1 year after laparoscopic adjustable gastric banding surgery. Material and Methods. In total, 103 patients (37 subjects with and 66 subjects without type 2 diabetes mellitus) were studied preoperatively and again 1 year after laparoscopic adjustable gastric banding. Results. One year after laparoscopic adjustable gastric banding, the leptin concentrations decreased significantly in both treatment groups, while the adiponectin levels increased significantly in the nondiabetic patients (11.19 μg/mL [SD 7.20] vs. 15.58 μg/mL [SD 7.8], P=0.003) and tended to increase in the group of the patients with type 2 diabetes mellitus (8.98 μg/mL [SD 6.80] vs. 13.01 μg/mL [SD 12.14], P>0.05). A considerable decrease in the insulin resistance indices was noted in the patients with type 2 diabetes mellitus 1 year after the intervention, and it was followed by a partial or complete remission of type 2 diabetes mellitus in 23 (85.19%) of the 27 investigated diabetic patients. The postoperative insulin resistance indices in the patients with type 2 diabetes mellitus became similar to the values in the nondiabetic subjects. Conclusions. Weight loss after laparoscopic adjustable gastric banding is associated with a significant increase in adiponectin secretion in nondiabetic morbidly obese patients and with improvement in adiponectin secretion in type 2 diabetes individuals. In subjects with type 2 diabetes, this surgical intervention results in a significant reduction in blood glucose and insulin resistance.

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Impact of Gastric Prolapse after Laparoscopic Adjustable Gastric Banding for Morbid Obesity

The American Surgeon ◽

10.1177/000313481408001135 ◽

2014 ◽

Vol 80 (11) ◽

pp. 1164-1168

Author(s):

John P. Davis ◽

Damien J. LaPar ◽

Bruce D. Schirmer ◽

Peter T. Hallowell

Keyword(s):

Gastric Banding ◽

Laparoscopic Adjustable Gastric Banding ◽

Adjustable Gastric Banding ◽

Laparoscopic Gastric Banding ◽

Morbidly Obese ◽

Patient Demographics ◽

Average Patient ◽

Low Incidence ◽

The Impact ◽

Univariate Analyses

Gastric prolapse (GP) after laparoscopic adjustable gastric banding (LAGB) remains a complication that has the potential to result in significant morbidities. The purpose of this study was to evaluate the incidence of GP after LAGB and to determine its impact on patient outcomes among the morbidly obese. From 2005 to 2012, 379 consecutive morbidly obese patients underwent LAGB procedures at a single institution. Patients were placed into two groups based on the occurrence of gastric prolapse (GP vs no GP). Patient demographics and risk factors, operative features, and postoperative outcomes were analyzed by univariate analyses to assess the impact of GP. Average patient age was 47 ± 29 years and patients were commonly female (80%) with a median body mass index (BMI) of 44 kg/m2. Incidence of GP was 4.2 per cent (n = 16). LAGB median BMIs at 1 month and 1 year were 41 and 36 kg/m2. There was no difference in 1-year weight loss (BMI GP: 36 kg/m2 vs no GP: 36 kg/m2, P = 0.617). Laparoscopic gastric banding results in significant weight reduction and a low incidence of gastric prolapse. Gastric prolapse has no difference in 1-year postoperative median BMI when compared with patients who did not prolapse.

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