Long-Term Results of Laparoscopic Adjustable Gastric Banding in French adolescents: The Utmost Importance of Follow-Up.

OBJECTIVES To investigate the long-term follow-up (FU) and effectivity of laparoscopic adjustable gastric banding (LAGB) in a French adolescent cohort. METHODS We retrospectively analyzed the results of LAGB at our institution. We collected information on FU, AGB status, weight-related parameters and comorbidity at multiple timepoints. RESULTS 56 patients (77% female) with a mean age of 16.5 years and a mean BMI of 45 kg/m2 underwent LAGB over a period of 12 years. The mean post-pediatric FU was 23 months. FU decreased progressively from 96% at 3 years to 54% and 29% at 6 and 9 years respectively. Loss to FU was 39% at last contact. AGB was removed in 17 patients (30%) and 12 patients (21%) underwent a second bariatric procedure. Mean BMI decreased by 11 kg/m2 at last contact (p < 0.001). The prevalence of most comorbidities also decreased significantly after 3 years. The mean excess weight loss (to reach a BMI of 25 kg/m2) was 47% during the first year post-surgery and further increased to 55% at last contact. CONCLUSION Overall, AGB resulted in significant weight loss. However, the increase in heterogeneity suggests that LAGB is more effective in some individuals than in others in the long-term. This study confirmed that LAGB is a valuable bariatric procedure in adolescents, either as a long term-term efficient or bridging method that would be replaced at the time of transition to adult care. The importance of a standardized long-term follow-up should always be emphasized.