Gastric band slippage

Gastric band slippage is a late complication of laparoscopic gastric banding surgery performed for obesity. It is reported to occur in 4-13% of cases 1-3.

It can occur in either an anterior or posterior direction.

Clinical presentation

Patients can present with cessation of weight loss, severe gastro-esophageal reflux, and nocturnal vomiting. If there is associated pouch dilation there may also by symptoms of obstruction.

Radiographic features

The diagnosis can be challenging as pouch slippage may occur transiently with progressive filling of the gastric stoma after which the band resumes a normal position.

Plain radiograph

The classic 'O' sign is seen on AP views which represents the gastric band being visible end on. This is highly suggestive of posterior band slippage.

Fluoroscopy

This shows abnormal band position as well as a stoma cavity with a maximal diameter exceeding 4 cm representing associated pouch dilation.

CT

This demonstrates herniation of the stomach through the gastric band. It may also demonstrate eccentric pouch dilation.

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Article information

rID: 45659
Synonyms or Alternate Spellings:
  • Slippage of gastric lap band

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Cases and figures

  • ERECT AP
    Case 1: classic O sign on AP view
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  • Case 2
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  • Case 3
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