Niville Erik, Dams Anne, Van Der Speeten Kurt, Verhelst Hans
Department of Abdominal Surgery, Ziekenhuis Oost-Limburg, Genk, Belgium.
Obes Surg. 2005 May;15(5):630-3. doi: 10.1381/0960892053923860.
Late band erosion is an uncommon complication after laparoscopic adjustable gastric banding (LAGB). Overall erosion rate in our practice is approximately 1.6%. Our first 10 erosion patients underwent a rebanding procedure after previous Lap-Band removal. This study gives the results of midterm follow-up.
10 patients underwent Lap-Band removal for erosion. Then, 4 to 6 months after band removal, between December 1999 and February 2002, the 10 patients underwent LAGB again. Post-operatively, patients were seen at least every 3 months, and routine endoscopy was performed 1, 2 and 3 years after rebanding. Follow-up in this study was 36-63 (mean 48) months.
No postoperative complications occurred; however, the first patient required conversion to laparotomy. Mean BMI was 40.6 (34-50) at the time of the initial LAGB, 34.3 (31-44) at the time of rebanding, and is 28.5 (22-38) at present. There have been 2 late complications: 1 pouch dilatation and 1 port leak. No re-erosions have developed. Satisfaction has been excellent in 9 patients and moderate in 1.
Laparoscopic rebanding is a safe, feasible, minimally invasive and efficacious option as a second bariatric procedure after Lap-Band removal for erosion. However, if the patient is not pleased with the first band, a different bariatric operation should be considered. Our results in the mid-term are excellent, but longer follow-up is necessary to draw definitive conclusions.
晚期束带侵蚀是腹腔镜可调节胃束带术（LAGB）后一种罕见的并发症。在我们的实践中，总体侵蚀率约为1.6%。我们的首批10例侵蚀患者在先前拆除Lap-Band后接受了重新束带手术。本研究给出了中期随访结果。
10例患者因侵蚀接受Lap-Band拆除。然后，在1999年12月至2002年2月期间，在拆除束带后4至6个月，这10例患者再次接受LAGB。术后，患者至少每3个月接受一次检查，并在重新束带后1年、2年和3年进行常规内镜检查。本研究的随访时间为36 - 63（平均48）个月。
未发生术后并发症；然而，首例患者需要转为开腹手术。初次LAGB时平均体重指数（BMI）为40.6（34 - 50），重新束带时为34.3（31 - 44），目前为28.5（22 - 38）。出现了2例晚期并发症：1例胃囊扩张和1例端口渗漏。未发生再次侵蚀。9例患者满意度极佳；1例患者满意度中等。
腹腔镜重新束带作为侵蚀性Lap-Band拆除后的第二次减肥手术，是一种安全、可行、微创且有效的选择。然而，如果患者对首个束带不满意，则应考虑采用不同的减肥手术。我们的中期结果极佳，但需要更长时间的随访才能得出明确结论。
