Results after laparoscopic adjustable gastric banding in patients over 55 years of age

Background: Laparoscopic adjustable gastric banding (LAGB) has become the most popular bariatric intervention in Europe. International guidelines recommended age limits for bariatric surgery of 18-60 years. The aim of this study was to evaluate the immediate results in morbidly obese patients >55 years old, treated with LAGB. Methods: Between January 1996 and January 2004, 350 patients underwent LAGB. 24 (6.8%) were >55 years old (Group A), mean age 58.6 +/- 3.3 years, mean preoperative BMI 42.3 +/- 4.5 kg/m(2). A comparative randomized analysis with 24 patients younger than age 55 years was performed (Group B: mean age 41.2 +/- 9.6 years, mean BMI 42.1 +/- 3.6 kg/m(2)). Baseline clinical features, operative parameters and postoperative results were evaluated. Results: No perioperative complications were recorded. Conversion rate and mortality were nil. Major postoperative complications occurred in 2 patients (8.3%) from Group A (1 intragastric prosthesis migration, 1 pouch dilatation) and 2 patients (8.3%) from Group B (intragastric migrations). Reoperation was needed in 3 cases, and one erosion (Group B) is on the waiting list for removal. Minor complications: 1 port infection in each group required ambulatory port substitution; 1 intraperitoneal port-catheter disconnection (Group B) was successfully treated laparoscopically. Mean follow-up was 31.7 months (Group A) and 33.0 months (Group B). Mean postoperative BMI at 12 and 24 months was 35.9 +/- 4.2 and 33.8 +/- 4.9 for Group A, and 33.8 +/- 4.6 and 33.2 +/- 6.0 for Group B. Conclusion: There have been no significant differences in results between the 2 groups. LAGB has been safe and effective in patients >55 years old.