Laparoscopic adjustable gastric banding for the treatment of morbidly obese patients: early outcome in a Chinese cohort

SKH Wong, WY So, PYP Yau, AKL Chan, S Lee, PN Chan, FCC Chow, SSC Chung
Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong

OBJECTIVE. To evaluate the efficacy of laparoscopic adjustable gastric banding in the management of morbid obesity in a cohort of Chinese patients.

DESIGN. Cohort study.

SETTING. University teaching hospital, Hong Kong.

PATIENTS. From August 2002 to September 2003, 10 patients (6 male, 4 female) with a median age of 34 years (range, 23-48 years) underwent laparoscopic adjustable gastric banding to treat morbid obesity. Considerable co-existing diseases were present in 90% of the cases. We instituted a team approach that allowed every patient to see our dietitian, physician, psychiatrist (if necessary), and surgeon prior to deciding on the procedure to be used.

MAIN OUTCOME MEASURES. Excessive body weight loss, quality-of-life score (SF36), and co-morbidities improvement.

RESULTS. The 10 patients had a median weight of 127 kg (range, 115-196 kg) and median body mass index of 47 kg/m(2) [range, 38-67 kg/m(2)]. The operation was successful in all patients with a median operating time of 110 minutes (range, 75-240 minutes). The median hospital stay was 3 days (range, 3-4 days) and three of the patients required overnight observation in the intensive care unit because of severe sleep apnoea and asthma. The median follow-up period was 12 months (range, 1-18 months). The mean weight loss at 6, 12, and 18 months was 19.3, 22.4, and 25.9 kg, respectively. Mean percentage of excessive weight loss at 6, 12, and 18 months was 34.9%, 36.5%, and 40.5%, respectively. Unsatisfactory weight loss (<20 kg) occurred in three patients because of poor dietary compliance and non–follow-up. Surgery also considerably improved the patients’
co-morbidities (hypertension, diabetes, and obstructive sleep apnoea) and the quality of life.

CONCLUSION. In the short term, laparoscopic adjustable gastric banding is certainly an effective procedure for morbid obesity, which results in a substantial weight loss and improvement of co-existing morbidities. Longer follow-up will show whether this weight loss is maintainable.

Hong Kong Med J 2005;11:20-9

Key words: Laparoscopy; Morbid obesity; Quality of life