Pregnancy and the Band - re revisions

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Obesity Surgery

Volume 21, Number 9, 1362-1369, DOI: 10.1007/s11695-010-0235-7

Clinical Research

Does Pregnancy Increase the Need for Revisional Surgery After Laparoscopic

Adjustable Gastric Banding?

N. Haward, A. Brown and E. O'Brien

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Scroll upScroll downReferences (18)Export CitationAboutAbstract

Background

Over 80% of laparoscopic adjustable gastric banding (LAGB) patients are women,

and approximately half of these are of reproductive age; therefore, pregnancy

post-LAGB is common. It is not known if pregnancy increases the need for

revisional procedures. We compare the incidence of revisions in two matched

cohorts of LAGB patients, with or without subsequent pregnancy.

Methods

From September 1994 to May 2009, 5,467 patients underwent LAGB at the Centre for

Bariatric Surgery, Australia. Women with births post-LAGB were matched to

controls, with a " matched follow-up date " calculated equivalent to pregnancy.

Rates of primary and overall revisions for band-related (erosions and proximal

pouch dilatations) and port/tubing complications were compared for cases and

controls at 2 and 3 years post-pregnancy.

Results

One hundred eighty-nine women had & #8805;1 pregnancies post-LAGB, including 137

with follow-up at 2 years and 104 at 3 years post-pregnancy. There was no

significant difference in band or port/tubing revisions between groups at either

time point: 16.8% vs 10.5% (p & #8201;= & #8201;0.13) and 23.9% vs 14.6%

(p & #8201;= & #8201;0.09) for primary band revisions, and 5.8% vs 5.3%

(p & #8201;= & #8201;0.84) and 10.5% vs 6.6% (p & #8201;= & #8201;0.35) for primary

port/tubing revisions at 2 and 3 years, respectively. Percentage excess weight

loss (%EWL) 3 years post-pregnancy was similar (47.9% vs 47.7%). Pregnancy LAGB

management was not found to affect revisions; however, less time between LAGB

and pregnancy was associated with a higher rate of primary band revisions

(p & #8201;= & #8201;0.03).

****Conclusion

These data suggest that pregnancy post-LAGB does not affect revision rate or

%EWL; however, a shorter time between LAGB operation and pregnancy may

predispose to band revisions.