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Primordial Influence of Post-operative Compliance on Weight Loss After Adolescent Laparoscopic Adjustable Gastric Banding

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Abstract

Background

Accumulating evidence suggests that the benefits seen in adult bariatric surgery can be reproduced in adolescents. In contrast with North America, bariatric surgery in adolescents is still not well accepted in Europe and indications and protocols have still to be formulated.

Methods

This prospective study tested the gastric banding procedure in 49 patients operated in a single French institution since 2008. The mean age at surgery was 16.2 ± 0.9 years with a weight of 118.8 ± 22.3 kg and body mass index of 42.5 ± 5.9 kg/m2.

Results

At 6, 12 and 24 months after surgery, weight was 103.7 ± 20.8 kg, 98.7 ± 21 kg and 93.6 ± 19.3 kg, respectively (p < 0.001), corresponding to excess weight loss (EWL) of 31.6 ± 17.2 %, 41.8 ± 21.4 % and 59.1 ± 24.9 % (p < 0.001), respectively. Multivariate analysis showed that the number of consultations per year was the only variable significantly associated to weight loss. Metabolic disorders were corrected, with a decreased prevalence of insulin resistance from 100 to 17 % and normalisation of homeostasis model assessment-insulin resistance (HOMA-IR) at 24 months (2.09 ± 0.95). Band-related complications were five slippages, one psychological intolerance and two ports repositioning. Six patients (12 %) had the device explanted. The death of a patient was an exceptionally severe adverse event.

Conclusion

Given frequent follow-up support by a multidisciplinary team, laparoscopic adjustable gastric banding (LAGB) surgery in adolescent results in sustained weight loss. However, even exceptional, potentially serious complications are possible and long-term follow-up is needed to evaluate the risk/benefit ratio at 5 or 10 years after LAGB surgery.

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References

  1. Nieman P, Leblanc CM, Canadian Paediatric Society, et al. Psychosocial aspects of child and adolescent obesity. Paediatr Child Health. 2012;17:205–8.

    PubMed  PubMed Central  Google Scholar 

  2. Druet C, Dabbas M, Baltakse V, et al. Insulin resistance and the metabolic syndrome in obese French children. Clin Endocrinol. 2006;64:672–8.

    Article  Google Scholar 

  3. Loomba R, Sirlin CB, Schwimmer JB, et al. Advances in pediatric nonalcoholic fatty liver disease. Hepatology. 2009;50:1282–93.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  4. Verhulst SL, Schrauwen N, Haentjens D, et al. Sleep-disordered breathing in overweight and obese children and adolescents: prevalence, characteristics and the role of fat distribution. Arch Dis Child. 2007;92:205–8.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Kelleher DC, Merrill CT, Cottrell LT, et al. Recent national trends in the use of adolescent inpatient bariatric surgery: 2000 through 2009. JAMA Pediatr. 2013;167:126–32.

    Article  PubMed  Google Scholar 

  6. Lioret S, Touvier M, Dubuisson C, et al. Trends in child overweight rates and energy intake in France from 1999 to 2007: relationships with socioeconomic status. Obesity. 2009;17:1092–100.

    Article  PubMed  Google Scholar 

  7. Sjöström L, Peltonen M, Jacobson P, et al. Bariatric surgery and long-term cardiovascular events. JAMA. 2012;307:56–65.

    Article  PubMed  Google Scholar 

  8. Treadwell JR, Sun F, Schoelles K. Systematic review and meta-analysis of bariatric surgery for pediatric obesity. Ann Surg. 2008;248:763–76.

    Article  PubMed  Google Scholar 

  9. McGovern L, Johnson JN, Paulo R, et al. Clinical review: treatment of pediatric obesity: a systematic review and meta-analysis of randomized trials. J Clin Endocrinol Metab. 2008;93:4600–5.

    Article  PubMed  CAS  Google Scholar 

  10. Pratt JS, Lenders CM, Dionne EA, et al. Best practice updates for pediatric/adolescent weight loss surgery. Obesity. 2009;17:901–10.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Jen HC, Rickard DG, Shew SB, et al. Trends and outcomes of adolescent bariatric surgery in California, 2005–2007. Pediatrics. 2010;126:e746–53.

    Article  PubMed  Google Scholar 

  12. Black JA, White B, Viner RM, et al. Bariatric surgery for obese children and adolescents: a systematic review and meta-analysis. Obes Rev. 2013;14:634–44.

    Article  PubMed  CAS  Google Scholar 

  13. O’Brien PE, Sawyer SM, Laurie C, et al. Laparoscopic adjustable gastric banding in severely obese adolescents: a randomized trial. JAMA. 2010;303:519–26.

    Article  PubMed  Google Scholar 

  14. Lee JM, Okumura MJ, Davis MM, et al. Prevalence and determinants of insulin resistance among U.S. adolescents: a population-based study. Diabetes Care. 2006;29:2427–32.

    Article  PubMed  Google Scholar 

  15. Diggle P, Heagerty P, Liang KY, et al. Analysis of longitudinal data. 2nd ed. Oxford: Oxford University Press; 2002.

    Google Scholar 

  16. Lee DY, Guend H, Park K, et al. Outcomes of laparoscopic Roux-en-Y gastric bypass versus laparoscopic adjustable gastric banding in adolescents. Obes Surg. 2012;22:1859–64.

    Article  PubMed  Google Scholar 

  17. Angrisani L, Cutolo PP, Formisano G, et al. Laparoscopic adjustable gastric banding versus Roux-en-Y gastric bypass: 10-year results of a prospective, randomized trial. Surg Obes Relat Dis. 2013;9:405–13.

    Article  PubMed  Google Scholar 

  18. Chakravarty PD, McLaughlin E, Whittaker D, et al. Comparison of laparoscopic adjustable gastric banding (LAGB) with other bariatric procedures; a systematic review of the randomised controlled trials. Surgeon. 2012;10:172–82.

    Article  PubMed  CAS  Google Scholar 

  19. Pourcher G, De Filippo G, Ferretti S, et al. Short-term results of single-port sleeve gastrectomy in adolescents with severe obesity. Surg Obes Relat Dis. 2015;11:65–9.

  20. Holterman AX, Browne A, Tussing L, et al. A prospective trial for laparoscopic adjustable gastric banding in morbidly obese adolescents: an interim report of weight loss, metabolic and quality of life outcomes. J Pediatr Surg. 2010;45:74–9.

    Article  PubMed  Google Scholar 

  21. Spivak H, Abdelmelek MF, Beltran OR, et al. Long-term outcomes of laparoscopic adjustable gastric banding and laparoscopic Roux-en-Y gastric bypass in the United States. Surg Endosc. 2012;26:1909–19.

    Article  PubMed  Google Scholar 

  22. Pilone V, Mozzi E, Schettino AM, et al. Improvement in health-related quality of life in first year after laparoscopic adjustable gastric banding. Surg Obes Relat Dis. 2012;8:260–8.

    Article  PubMed  Google Scholar 

  23. Brown WA, Egberts KJ, Franke-Richard D, et al. Erosions after laparoscopic adjustable gastric banding: diagnosis and management. Ann Surg. 2013;257:1047–52.

    Article  PubMed  Google Scholar 

  24. Chevallier JM. Gastric banding using adjustable silastic ring in 2010. Technique, indications, results, and management. J Visc Surg. 2010;147(5 Suppl):e21–9.

    Article  PubMed  Google Scholar 

  25. Chang SH, Stoll CR, Song J, et al. The effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis, 2003–2012. JAMA Surg. 2014;149:275–87.

  26. Inge TH, Zeller MH, Jenkins TM, et al. Perioperative outcomes of adolescents undergoing bariatric surgery: the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study. JAMA Pediatr. 2014;168:47–53.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Owers C, Ackroyd R. A study examining the complications associated with gastric banding. Obes Surg. 2013;23:56–9.

    Article  PubMed  Google Scholar 

  28. Scozzari G, Toppino M, Famiglietti F, et al. 10-year follow-up of laparoscopic vertical banded gastroplasty: good results in selected patients. Ann Surg. 2010;252:831–9.

    Article  PubMed  Google Scholar 

  29. Schouten R, van’t Hof G, Feskens PB. Is there a relation between number of adjustments and results after gastric banding? Surg Obes Relat Dis. 2013;9:908–12.

    Article  PubMed  Google Scholar 

  30. Sysko R, Hildebrandt TB, Kaplan S, et al. Predictors and correlates of follow-up visit adherence among adolescents receiving laparoscopic adjustable gastric banding. Surg Obes Relat Dis. 2014;10:914–20.

  31. Sysko R, Devlin MJ, Hildebrandt TB, et al. Psychological outcomes and predictors of initial weight loss outcomes among severely obese adolescents receiving laparoscopic adjustable gastric banding. J Clin Psychiatry. 2012;73:1351–7.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Colquitt JL, Picot J, Loveman E, et al. Surgery for obesity. Cochrane Database Syst Rev. 2009;2, CD003641.

    PubMed  Google Scholar 

Download references

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Author information

Authors and Affiliations

  1. AP-HP, Hôpital Necker-Enfants Malades, Service de Chirurgie Pédiatrique Viscérale, 149 rue de Sevres, 75015, Paris, France

    Naziha Khen-Dunlop, Erik Hervieux, Jean-Luc Michel, Yves Aigrain & Yann Révillon

  2. AP-HP, Hôpital Necker-Enfants malades, Service de Gastroenterologie et Nutrition Pédiatrique, Paris, France

    Myriam Dabbas & Olivier Goulet

  3. AP-HP, Hôpital Bicêtre, Unité Médico-chirurgicale Obésité de l’Adolescent, Service de Médecine des Adolescents, Le Kremlin Bicêtre, France

    Gianpaolo De Filippo

  4. AP-HP, Hôpital Necker-Enfants Malades, Département de Biostatistiques, Paris, France

    Jean-Philippe Jais

  5. AP-HP, Hôpital Necker-Enfants Malades, Départment d’Anesthésie et Réanimation, Paris, France

    Caroline Télion

  6. AP-HP, Hôpital Européen Georges Pompidou, Service de Chirurgie Générale, Paris, France

    Jean-Marc Chevallier

  7. AP-HP, Hôpital Bicêtre, Service d’Endocrinologie et Diabétologie Pédiatrique, Le Kremlin Bicêtre, France

    Pierre Bougnères

  8. Université Paris Descartes, Paris, France

    Naziha Khen-Dunlop, Jean-Philippe Jais, Yves Aigrain, Olivier Goulet & Yann Révillon

Authors
  1. Naziha Khen-Dunlop
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  2. Myriam Dabbas
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  3. Gianpaolo De Filippo
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  4. Jean-Philippe Jais
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  5. Erik Hervieux
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  6. Caroline Télion
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  7. Jean-Marc Chevallier
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  8. Jean-Luc Michel
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  9. Yves Aigrain
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  11. Olivier Goulet
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  12. Yann Révillon
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Corresponding author

Correspondence to Naziha Khen-Dunlop.

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Khen-Dunlop, N., Dabbas, M., De Filippo, G. et al. Primordial Influence of Post-operative Compliance on Weight Loss After Adolescent Laparoscopic Adjustable Gastric Banding. OBES SURG 26, 98–104 (2016). https://doi.org/10.1007/s11695-015-1725-4

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  • DOI: https://doi.org/10.1007/s11695-015-1725-4

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