Martines G, Picciariello A, Ugenti I, Lagovardou E, Digennaro R, Capuano P
G Chir. 2017 Sep-Oct;38(5):225-228. doi: 10.11138/gchir/2017.38.5.225.
Laparoscopic adjustable gastric banding (LAGB) migration is an uncommon late complication after bariatric surgery. It usually presents with an unexplained weight increase or without any symptom. Current guidelines do not establish the timing of a clear endoscopic follow-up to prevent and/or to treat this kind of complication.
Long-term follow-up was performed in 217 patients with LAGB (37 underwent surgery in other bariatric centers). At the endoscopic check, 3 patients presented banding erosion respectively 7, 9 and 11 years after surgery. In all three cases the patients, lost at the follow-up in their bariatric centers, had weight gain. During the endoscopy was treated just one patient because of the advanced migration. For the other patients, with a minimal migration, the choice was to perform an endoscopic surveillance every 4 months.
Removal of eroded gastric banding with common endoscopic devices is feasible, safe, and effective.
With our experience we suggest to perform planned endoscopy at least within 2 years in order to guarantee the early diagnosis and managing of gastric banding erosion.
腹腔镜可调节胃束带术（LAGB）移位是减肥手术后一种罕见的晚期并发症。它通常表现为不明原因的体重增加或无任何症状。目前的指南未明确规定进行内镜随访以预防和/或治疗此类并发症的时间。
对217例行LAGB手术的患者进行了长期随访（其中37例在其他减肥中心接受手术）。在内镜检查时，3例患者分别在术后7年、9年和11年出现束带侵蚀。在所有这三例病例中，在减肥中心随访时体重增加。在内镜检查时，仅对1例因移位严重的患者进行了治疗。对于其他移位轻微的患者，选择每4个月进行一次内镜监测。
使用普通内镜设备移除侵蚀的胃束带是可行、安全且有效的。
根据我们的经验，我们建议至少在2年内进行计划性内镜检查，以确保早期诊断和处理胃束带侵蚀。
