© FD-Communications Inc. Obesity Surgery, 14, 2004 1343 Obesity Surgery, 14, 1343-1348 Background: Despite its simplicity, safety and good short-term results, progressive weight regain and a high incidence of complications have been reported after the adjustable silicone gastric banding (ASGB). The aim of this study is to evaluate the long-term results of this operation in our patient population. Methods: Between 1990 and 1996, 45 morbidly obese patients underwent insertion of an ASGB. The trend of the patients’ BMI over time was studied using a linear mixed effect model adjusted for the preoper- ative BMI. So as to estimate the cumulative probabil- ity of band removal and the cumulative hazard func- tion, Λ(t) Kaplan-Meier analysis was used. Results: 1 year after the operation, the average BMI was 79% of its preoperative value, which then increased linearly over time. The slope of the regres- sion line was estimated at β=0.42, indicating an aver- age increase of 0.42 BMI units per year. 27 bands (60%) were removed because of specific late compli- cations. The cumulative risk of band removal increased linearly with time. The hazard rate was esti- mated to be λ=0.008 events/patient/month, corre- sponding to 0.1 events/patient/year. Conclusions: ASGB yielded good short-term results, but the progressive weight regain and con- stant risk of complications in the long term tend to nullify the optimism. Key words: Morbid obesity, adjustable gastric banding, weight loss, long-term complications, device Introduction Adjustable silicone gastric banding (ASGB) became one of the procedures used in our department in a selected number of patients in 1990. This came about while searching for a gastric restrictive opera- tion which could be adopted as an alternative to bil- iopancreatic diversion (BPD), which has been per- formed routinely in our Department for over 25 years. 1 The reasons for our choice of ASGB were its simplicity, easy technical feasibility, safety and easy reversibility. Laparoscopic surgery, which reduces respiratory distress, ileus, pain and incisional hernia, is particu- larly advantageous for morbidly obese patients. Therefore, we became interested immediately in laparoscopic adjustable gastric banding (LAGB) when it was introduced by Belachew in 1993, 2 and shifted to that type of access in 1994. Despite its simplicity, the operation is not free from shortcomings; we encountered both early and late complications which required re-operative Thirteen Years of Follow-up in Patients with Adjustable Silicone Gastric Banding for Obesity: Weight Loss and Constant Rate of Late Specific Complications Giovanni Camerini, MD*; Gianfranco Adami, MD*; Giuseppe Maria Marinari, MD*; Ezio Gianetta*, MD; Fabio Pretolesi, MD†; Francesco Papadia, MD*; Paola Marini, MD*; Federica Murelli, MD*; Flavia Carlini, MD*; Cesare Stabilini, MD*; Maria Pia Sormani, PhD‡; Nicola Scopinaro, MD* *Department of Surgery, †Department of Radiology, School of Medicine, University of Genoa, and the ‡Unit of Clinical Epidemiology and Trials, National Institute for Cancer Research, Genoa, Italy Reprint requests to: Prof. Nicola Scopinaro, DICMI - Semeiotica Chirurgica R, Università di Genova, Ospedale San Martino, Largo R. Benzi n.8, 16132 Genoa, Italy. Fax: 39 010 502754; e-mail: scopinar@unige.it