Zusammenfassung
Hintergrund: Das Gastric Banding ist eine weit verbreitete bariatrische Operation in Europa. Die
Häufigkeit von Langzeitkomplikationen wie Pouchdilatation, Slippage und Bandmigration
und der Langzeiteffekt der Gewichtsreduktion sind in Metaanalysen und wenigen Langzeitbeobachtungen
untersucht. Wir berichten über unsere Erfahrungen mit dem Gastric Banding. Methoden: In 10 Jahren wurde bei 168 Patienten eine Gastric Banding-Operation durchgeführt.
Präoperative Daten, der postoperative Gewichtsverlust und Langzeitkomplikationen wurden
prospektiv erfasst und retrospektiv analysiert. Ergebnisse: Das Durchschnittsalter der Patienten war 41,7 Jahre mit einem mittleren BMI von 49,6
kg/m². In den ersten 30 Tagen postoperativ traten keine Todesfälle auf. Die Konversionsrate
betrug 7,1 %. 79,8 % der Patienten (n = 134) unterzogen sich einem regelmäßigem Follow-up
(mittlere Nachbeobachtungszeit 66,7 Monate). Postoperative Langzeitkomplikationen
traten bei 22,5 % der Patienten auf. 30 Komplikationen (17,8 %) waren Band-abhängige
Komplikationen und 8 (4,7 %) waren Komplikationen von Seiten des Portsystems. Der
mittlere Übergewichtsverlust betrug 39,6; 47,3; 44,2; 43,4 und 32 % nach 1, 2, 4,
5, und 8 Jahren. Fazit: Durch das Gastric Banding kann ein effektiver Gewichtsverlust erzielt werden. Jedoch
beeinflussen Band-abhängige Komplikationen und funktionelle Aspekte die Langzeitergebnisse.
Richtlinien zur Wahl der geeigneten bariatrischen Methode sind notwendig, um die Therapieversager
und die Komplikationsrate zu reduzieren.
Abstract
Background: Adjustable gastric banding is a popular bariatric operation in Europe. The rate of
long-term complications like pouch dilatation, slippage and band migration and the
long-term effect of weight loss are reported in meta-analysis and few studies for
a period of more than five years. We report on experiences after gastric banding.
Methods: Over a period of 10 years 168 patients with morbid obesity were treated with gastric
banding. Preoperative data, postoperative weight loss and long-term complications
were prospectively obtained and retrospectively analyzed. Results: Mean age of the patients was 41.7 years with a mean preoperative BMI of 49.6 kg/m².
No intraoperative or postoperative death occurred in the first 30 postoperative days.
Intraoperative conversion rate was 7.1 %. 79.8 % of the patients (n = 134) were available
for follow up (mean follow-up time 66.7 months). Long-term complications occurred
in 22.5 % of the patients. 30 complications (17.8 %) were related to the band and
8 (4.7 %) to the access-port or to the tube. Mean excess weight loss was 39.6, 47.3,
44.2, 43.4 and 32 % after 1, 2, 4, 5 and 8 years. Conclusions: Laparoscopic gastric banding can achieve an effective weight loss. However band-related
and functional complications will influence the late outcome. Pathways to choose the
best surgical method for the individual patient are necessary to reduce failures after
gastric banding.
Schlüsselwörter
morbide Adipositas - bariatrische Chirurgie - Gastric Banding - Slippage - Pouchdilatation
- Bandmigration
Key words
morbid obesity - bariatric surgery - gastric banding - slippage - pouch dilatation
- band migration
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Dr. Christine Stroh
Departement für Allgemein- und Viszeralchirurgie · SRH Wald-Klinikum Gera gGmbH
Straße des Friedens 122
07548 Gera
Phone: 03 65/8 28 31 01
Fax: 03 65/8 28 31 02
Email: Christine.Stroh@wkg.srh.de
