Laparoscopic adjustable gastric banding in adolescent:
safety and efficacy
Aayed R. Al-Qahtani*
Division of Pediatric Surgery, King Khalid University Hospital, Riyadh 11671, Saudi Arabia
Background: Obesity prevalence is rapidly increasing among children and adolescents worldwide. It is
considered one of the most alarming public health issues facing the world today. The adult experience
has demonstrated that surgery is the only effective means of achieving persistent weight loss in obese
patients. However, little is known about bariatric surgery in children and adolescents. The aim of this
study is to evaluate the safety and efficacy of laparoscopic adjustable gastric banding (LAGB) in this
group of patients.
Methods: A retrospective review included all children and adolescents who underwent LAGB from
January 2003 to December 2005.
Results: Fifty-one patients underwent LAGB. The mean age was 16.8 years (range, 9-19), and the mean
body mass index was 49.9 kg/m2(range, 38-63). Mean excess weight loss was 42% at 6 months and
60% at 1 year follow-up. The most prevalent comorbidities were obstructive sleep apnea, limited
physical activities, hypertension, and diabetes mellitus. Band adjustments were performed under
fluoroscopic guidance in 5 patients and direct access as a clinic procedure in the remaining. One
patient required port repositioning under fluoroscopic guidance. The mean follow-up was 16 months
(range, 3-34). There was no mortality or significant postoperative complications.
Conclusion: The absence of significant nutritional deficiency, the continued adjustability, and potential
reversibility of LAGB make it the safest, least invasive, and most effective bariatric surgery that can be
offered to the young and adolescent population.
D 2007 Elsevier Inc. All rights reserved.
Obesity prevalence is rapidly increasing among children
and adolescents worldwide. It is considered one of the most
alarming public health issues facing the world today [1-4].
Although believed in the past to be less frequently
associated with increased morbidity than in adults, obesity
in children is now recognized to be associated with insulin
resistance, hypertension, hyperlipemia, hepatic steatosis,
sleep apnea, and orthopedic complications [5-8]. The
physical and social effects of severe obesity in young
people are devastating . The greatest concern and
potential public health effects are that obesity during the
pediatric age is a strong predictor of obesity in adulthood
[10-13]. Studies show that 50% to 77% of children and
adolescents who are obese carry their obesity into adult-
hood, thus increasing their risks of developing serious and
often life-threatening conditions. The risk increases to 80%
if one of the parents is also obese [10,14].
0022-3468/$ – see front matter D 2007 Elsevier Inc. All rights reserved.
* Division of Pediatric Surgery, College of Medicine, PO Box 84147,
Riyadh 11671, Saudi Arabia. Tel.: +966 14671575.
E-mail address: email@example.com.
Journal of Pediatric Surgery (2007) 42, 894–897