As Gastric Banding Increases, So May Complications

THURSDAY, Dec. 22 (HealthDay News) — Use of gastric bands as a
weight-loss aid is increasing, and doctors need to be alert for potential
complications years later, say the authors of a new case report.

The report details problems that developed two years after a
49-year-old British woman underwent the weight-loss procedure. She sought
treatment at a hospital after having night sweats and a persistent cough
that produced green and yellow sputum for four months. Her medical history
showed that she had asthma that had not responded to treatment and that
she had been fitted with a laparoscopic adjustable gastric band in
September 2008.

Gastric band surgery involves placement of a band around the top
portion of the stomach. This creates a small pouch to receive food, which
then slowly empties into the larger, lower stomach. Because of the band,
people feel full after eating small amounts of food.

Since receiving the gastric band, the woman’s body mass index (BMI) had
decreased from 45 to 33, according to the report published in the Dec. 22
online edition of The Lancet. A BMI of 30 or more is considered
obese.

A chest X-ray revealed that the woman had a cavity within the left
upper zone. After ruling out tuberculosis, the doctors suspected the
woman’s problems were caused by the gastric band.

The specific issues appeared to be repeated aspiration of ingested food
(causing reflux down her windpipe and subsequent lung damage) and
cavitation (holes formed in the lung, often due to infection) caused by
the gastric band fitting, according to a journal news release.

After antibiotics provided only limited relief, doctors emptied the
fluid from the gastric band. The woman’s symptoms quickly vanished. At her
last follow-up visit, after her gastric band was cautiously refilled, her
BMI was 35 and she was still symptom-free, the investigators reported.

The report authors noted that band slippage and erosion are the most
common complications in patients with gastric bands, while lung-related
problems are rare.

But delayed lung complications “can present with asthma-like symptoms
and can be misdiagnosed if not properly investigated,” concluded Dr. Adam
Czapran, of the department of respiratory medicine and coronary care at
Russells Hall Hospital in Dudley, West Midlands, U.K., and colleagues.

“Patients who have undergone laparoscopic adjustable gastric banding
should have chest radiography or thoracic CT scan, or both, if they
present with respiratory symptoms,” Czapran’s team wrote in the journal
news release. “Withdrawal of the fluid from the band should be done as
soon as possible to relieve the obstruction. Given the increasing
frequency of people undergoing interventional procedures to aid weight
loss, recognition of the short-term and long-term complications is
paramount.”

More information

The U.S. National Library of Medicine has more about laparoscopic gastric banding.

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