Restrictive procedures in the treatment of morbid obesity -: Vertical banded gastroplasty vs. adjustable gastric banding

Vertical banded gastroplasty (VBG) has been in clinical use since 1979 and the adjustable gastric banding (AGB) since 1985. The aim of this study was to compare the outcome, short- and long-term complications of the two procedures. Within a period of 9 years (1992-2001) 1011 gastric restrictive procedures were performed by two surgeons in the course of a prospective non-randomized comparative trial. 563 VBG's via laparotomy and 448 laparoscopic AGB's were included into the study. The mean BMI of the patients was 46 kg/m(2) in both groups. The mean duration of follow up was 60 months (range 6 to 108 months). No statistical significant difference in outcome in terms of weight loss, reduction of co-morbidity and improvement in quality of life following ASGB or VBG was observed. The hospital mortality rate was 0.3 % (2 VBG, 1 AGB). The overall reintervention rate for long-term complications was 15.6% for the VBG and 7% for the AGB group (p < 0.0001). The AGB is entirely reversible and the less invasive procedure preserving an intact anatomy of the stomach. A trend in favour of the AGB is observed.