Results after laparoscopic adjustable gastric banding in patients over 55 years of age.

Author: Silecchia G, Greco F, Bacci V, Boru C, Pecchia A, Casella G, Rizzello M, Basso N

Author affiliation: Department of General Surgery "Paride Stefanini", Rome, Italy. gianfranco.silecchia@uniroma1.it

Publication date & source: 2005.03, Obes Surg., 15(3):351-6.

Publication type: Clinical Trial; Comparative Study ; Randomized Controlled Trial

BACKGROUND: Laparoscopic adjustable gastric banding (LAGB) has become the most popular bariatric intervention in Europe. International guidelines recommended age limits for bariatric surgery of 18-60 years. The aim of this study was to evaluate the immediate results in morbidly obese patients >55 years old, treated with LAGB. METHODS: Between January 1996 and January 2004, 350 patients underwent LAGB. 24 (6.8%) were >55 years old (Group A), mean age 58.6+/-3.3 years, mean preoperative BMI 42.3+/-4.5 kg/m2. A comparative randomized analysis with 24 patients younger than age 55 years was performed (Group B: mean age 41.2+/-9.6 years, mean BMI 42.1+/-3.6 kg/m2). Baseline clinical features, operative parameters and postoperative results were evaluated. RESULTS: No perioperative complications were recorded. Conversion rate and mortality were nil. Major postoperative complications occurred in 2 patients (8.3%) from Group A (1 intragastric prosthesis migration, 1 pouch dilatation) and 2 patients (8.3%) from Group B (intragastric migrations). Reoperation was needed in 3 cases, and one erosion (Group B) is on the waiting list for removal. Minor complications: 1 port infection in each group required ambulatory port substitution; 1 intraperitoneal portcatheter disconnection (Group B) was successfully treated laparoscopically. Mean follow-up was 31.7 months (Group A) and 33.0 months (Group B). Mean postoperative BMI at 12 and 24 months was 35.9+/-4.2 and 33.8+/-4.9 for Group A, and 33.8+/-4.6 and 33.2+/-6.0 for Group B. CONCLUSION: There have been no significant differences in results between the 2 groups. LAGB has been safe and effective in patients >55 years old.