Laparoscopic adjustable gastric banding in patients ≥60 years old:: Is it worthwhile?

Background: Laparoscopic adjustable gastric banding (LAGB) is an effective treatment for morbid obesity in younger patients, leading to improvements in related comorbidities and quality of life. Currently, little is known how these improvements apply to older patients. Methods: A prospective review was conducted of patients >= 60 years old undergoing LAGB. Weight loss, complications, changes in Short Form-36 (SF-36) scores, and a comprehensive postoperative co-morbidity, medication and quality of life questionnaire were used to assess performance. Results: 40 patients with mean age 65.8 years (range 60-72) and preoperative mean BMI of 42.2 kg/m(2) (range 33-54) underwent LAGB from February 2000 to September 2005. Mean excess weight lost at 2 years was 54%. 3 complications (7.5%) occurred (1 slippage and 2 access-port infections). There were no perforations, erosions or deaths. After a mean postoperative interval of 27 months, SF-36 scores improved significantly in 4 of 8 components and exceeded age-matched population controls in 3 components. Co-morbidity improvement was reported in 80% of patients with diabetes, 79% with dyslipidemia, 75% with obstructive sleep apnea, 72% with heartburn, 69% with hypertension, 60% with musculoskeletal pain, and 56% with anxiety/depression. Medication requirements reduced or ceased in 66% who required musculoskeletal analgesics, 43% of diabetics, 33% using bronchodilators, and 29% with hypertension. Sleep improved in 48%, self-esteem increased in 70%, and 72% had a better outlook on life. 82% were happy that they had undergone LAGB, and 91% would recommend LAGB to other older people. Conclusion: LAGB offers safe and effective weight loss, and improvement in co-morbidities and in quality of life in morbidly obese patients aged >= 60 years.