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Invited Critique
July 2011

To Band or to Bypass, That Is the Question: Comment on “Long-Term Outcomes of Laparoscopic Adjustable Gastric Banding”

Author Affiliations

Author Affiliation: Department of Surgery, Oregon Health and Science University, Portland, Oregon.

Arch Surg. 2011;146(7):807-808. doi:10.1001/archsurg.2011.36

Himpens et al present a series of 151 patients who underwent laparoscopic adjustable gastric banding (LAGB). Of these 151 patients, 82 (54.3%) were followed up for 12 years or longer. Of these 82 patients, 23 (28.0%) experienced band erosion, which was diagnosed at a mean time of 4 years, and 41 (50.0%) had their band removed. Those who still had the band in place lost 48% of their excess weight, whereas those who had their band removed (because they did not lose weight) lost only 22% of their excess weight. The number and type of comorbidities (eg, diabetes, hypertension, and sleep apnea) in this group of patients increased over time.