Authors' objectives:

This report reviews the available evidence on whether Laparoscopic Adjustable Gastric Banding (LAGB) results in similar improvements in health outcomes as does open or laparoscopic gastric bypass (GBY).

Authors' results and conclusions: Eight comparative trials of LAGB vs. GBY, enrolling 4,191 patients, and 57 single-arm series met the inclusion criteria for this Assessment. A total of 9 single-arm series met the additional follow-up criteria of at least 50% of enrolled patients available at 2 years' follow-up. Weight loss outcomes from these studies confirm the conclusions of previous TEC Assessments. Substantial weight loss does occur following LAGB; however, the amount of weight loss at 1 year is less than that seen following GBY. The percent excess weight lost (%EWL) at 1 year is approximately 40%, compared to 60% or higher for GBY. At time points longer than 1 year, some of the comparative studies report that the difference in weight loss between LAGB and GBY lessens; however, other studies do not. Weight loss outcomes from the 9 single-arm series with the most complete follow-up do not support the hypothesis that weight loss continues to increase after 1;2 years of follow-up. These studies also confirm that short-term (perioperative) complications are very low with LAGB, and lower than either open or laparoscopic GBY. Death is extremely rare, and serious perioperative complications probably occur at rates of less than 1%. The reported rates of long-term adverse events vary considerably. In the comparative trials, reoperations are reported in approximately 25% of patients, while in the single-arm studies the composite rate for reoperations is approximately half of this value (11.9%). The rates of other long-term complications are also highly variable; for example, the reported range of rates for band slippage is 1;36% and the range for port access problems is 2;20%.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.bcbs.com/blueresources/tec/contact-tec.html

Year Published: 2007

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: BlueCross BlueShield Association

Contact Address: BlueCross BlueShield Association, Technology Evaluation Center, 225 North Michigan Ave, Chicago, Illinois, USA. Tel: 888 832 4321

Contact Name: tec@bcbsa.com

Contact Email: tec@bcbsa.com

Copyright: BlueCross BlueShield Association (BCBS)