TY - JOUR
T1 - Prevention of pouch dilatation after laparoscopic adjustable gastric banding
AU - Zappa, Marco Antonio
AU - Micheletto, Giancarlo
AU - Lattuada, Ezio
AU - Mozzi, Enrico
AU - Spinola, Alessandra
AU - Meco, Massimo
AU - Roviaro, Giancarlo
AU - Doldi, Santo Bressani
PY - 2006/2
Y1 - 2006/2
N2 - Background: The major long-term complication of laparoscopic adjustable gastric banding (LAGB) is dilatation of the gastric pouch, that is reported with a frequency ranging from 1 to 25%, and often requires removal of the band. In addition to the usual recommendations of bariatric surgery centers and dietetic advice to prevent this complication, over the last 4 years we introduced a technical modification of the procedure. Methods: From Nov 1993 to Dec 2004, 684 morbidly obese patients underwent adjustable gastric banding, 83 patients by open surgery and 601 patients by laparoscopy. The first 323 patients (group A) were operated by the perigastric approach, and 57 patients (group B) were operated by the pars flaccida approach. Since Dec 2000, 304 patients (group C) were operated with a modified pars flaccida technique, which consisted in suturing the gastric lesser curvature below the band with one or two stitches to the right phrenic crus to secure the band in place. Results: In group A, the most important late complication was irreversible dilatation of the gastric pouch, which occurred in 35 patients (10.8%), and required removal of the band in 30 cases and replacement in 5. In group B, there were 3 pouch dilatations (5.2%). In group C, only 4 dilatations occurred (1.31%), which required 3 band removals and 1 band replacement Conclusion: Dilatation of the gastric pouch appears to be dramatically reduced by our minor technical modification of band placement.
AB - Background: The major long-term complication of laparoscopic adjustable gastric banding (LAGB) is dilatation of the gastric pouch, that is reported with a frequency ranging from 1 to 25%, and often requires removal of the band. In addition to the usual recommendations of bariatric surgery centers and dietetic advice to prevent this complication, over the last 4 years we introduced a technical modification of the procedure. Methods: From Nov 1993 to Dec 2004, 684 morbidly obese patients underwent adjustable gastric banding, 83 patients by open surgery and 601 patients by laparoscopy. The first 323 patients (group A) were operated by the perigastric approach, and 57 patients (group B) were operated by the pars flaccida approach. Since Dec 2000, 304 patients (group C) were operated with a modified pars flaccida technique, which consisted in suturing the gastric lesser curvature below the band with one or two stitches to the right phrenic crus to secure the band in place. Results: In group A, the most important late complication was irreversible dilatation of the gastric pouch, which occurred in 35 patients (10.8%), and required removal of the band in 30 cases and replacement in 5. In group B, there were 3 pouch dilatations (5.2%). In group C, only 4 dilatations occurred (1.31%), which required 3 band removals and 1 band replacement Conclusion: Dilatation of the gastric pouch appears to be dramatically reduced by our minor technical modification of band placement.
KW - Bariatric surgery
KW - Gastric pouch dilatation
KW - Laparoscopic adjustable gastric banding
KW - Morbid obesity
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U2 - 10.1381/096089206775565140
DO - 10.1381/096089206775565140
M3 - Article
C2 - 16469212
AN - SCOPUS:33644510786
VL - 16
SP - 132
EP - 136
JO - Obesity Surgery
JF - Obesity Surgery
SN - 0960-8923
IS - 2
ER -