Therapeutic effect of laparoscopic adjustable gastric banding for obesity

Objective To observe the efficacy and safety of laparoscopic adjustable gastric banding (LAGB) in the treatment of obesity and type 2 diabetes. Methods Patients with obesity who underwent LAGB (n=32) or laparoscopic sleeve gastrectomy(LSG) (n=34) in Chinese PLA General Hospital from April 2012 to April 2014 were enrolled in this study. Among them, there were 9 cases and 11 cases with type 2 diabetes in LAGBP group and LSG group, respectively. Anthropometric indicators, diabetesrelated indicators and postoperative complications were compared between the two groups. Results There was no significant difference between the two groups in preoperative baseline indicators (all P> 0.05) except age (P=0.027). The excess weight loss rates (%EWL) of LAGBP group was significantly lower than that of LSG group at 12 months after operation(57.52±13.53)% vs(73.43±10.78)%, P=0.000, but no significant difference was found at 24 and 36 months after operation(72.55±10.14)% vs(71.23±13.32)%, P=0.817; (71.23±13.35)% vs (67.43±15.32)%, P=0.299. The operating time(90.0±12.2) min vs (97.0±15.7)min, P=0.048, the amount of intraoperative blood loss(14.7±4.5) ml vs (20.3±10.8) ml, P=0.008 and the length of hospitalization(4.3±0.8) d vs (6.2±1.5) d, P=0.000 in group LAGBP were significantly lower than those in group LSG. While, there was no significant difference in T2DM remission rate (100% vs 90.91%, P=1.000) and incidence of postoperative complications (6.25% vs 8.82%, P=0.944) between two groups. Conclusion Compared with LSG, LAGB has shorter operating time, less intraoperative blood loss, shorter hospital stay and similar weight loss effect in the second to third year after operation, which is considered as an effective, safe and reversible metabolic procedure.