A systematic review of laparoscopic adjustable gastric banding for the treatment of obesity (update and re-appraisal)

Chapman A, Game P, O'Brien P, Maddern G, Kiroff G, Foster B, Ham J
Record ID 32003000005
Authors' objectives:

The aim of this systematic review was to assess the safety and efficacy of laparoscopic adjustable gastric banding for the treatment of obesity in comparison to the more established operations of vertical banded gastroplasty and gastric bypass.

Authors' results and conclusions: Laparoscopic adjustable gastric banding was associated with a mean short-term mortality rate of around 0.05% and an overall median morbidity rate of around 11.3%, compared with 0.50% and 23.6% for gastric bypass and 0.31% and 25.7% for vertical banded gastroplasty. In terms of weight loss, the comparative studies suggested that gastric bypass produced superior weight loss outcomes than either of the other two procedures, at least up to 2 years. Beyond 2 years gastric bypass continued to result in superior weight loss outcomes when compared to vertical banded gastroplasty. There was insufficient evidence to determine the relative merits in terms of weight loss of gastric banding and gastric bypass. Overall, all three procedures produced considerable weight loss in patients up to 4 years in the case of laparoscopic adjustable gastric banding (the maximum follow up available at the time of the review), and over 10 years in the case of the comparator procedures.
Authors' recommendations: The ASERNIP-S Review Group concluded that the evidence base was of average quality up to 4 years for laparoscopic adjustable gastric banding. Laparoscopic gastric banding is safer than vertical banded gastroplasty and Roux-en-Y gastric bypass, in terms of short-term mortality rates. Laparoscopic gastric banding is effective, at least up to 4 years, as are the comparator procedures. Up to 2 years the laparoscopic gastric band results in less weight loss than Roux-en-Y gastric bypass; from 2 ; 4 years there is insufficient evidence to conclude that Roux-en-Y remains more effective than laparoscopic gastric banding. Long-term efficacy of laparoscopic gastric banding remains unproven and further evaluation by randomised controlled trials is recommended to define its merits relative to the comparator procedures.
Authors' methods: Systematic review
Project Status: Completed
Year Published: 2002
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Australia
MeSH Terms
  • Gastroplasty
  • Laparoscopy
  • Obesity, Morbid
Organisation Name: Australian Safety and Efficacy Register of New Interventional Procedures-Surgical
Contact Address: ASERNIP-S 24 King William Street, Kent Town SA 5067 Australia Tel: +61 8 8219 0900
Contact Name: racs.asernip@surgeons.org
Contact Email: racs.asernip@surgeons.org
Copyright: Australian Safety and Efficacy Register of New Interventional Procedures - Surgical
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