The Effects of Laparoscopic Adjustable Gastric Banding on the Proximal Pouch and the Esophagus |
| |
Authors: | D Peternac MD R Hauser MD M Weber MD O Schöb MD |
| |
Institution: | (1) Department of Surgery, University of Zurich Hospital; Zurich, Switzerland |
| |
Abstract: | Background: Pouch development is a potentially serious problem following gastric banding, and re-operation is often demanded
to maintain long-term function of the lap band. Laparoscopic gastric banding was performed with two different calibrations
of the pouch. Within a period of 12 months, postoperative pouch behavior with regard to volume and shape was evaluated retrospectively,
as were changes in the distal esophagus. Methods: The pouches of 14 patients with intraperitoneal band positioning were calibrated at 25 ml. The volumes of 54 patients operated by a suprabursal technique were set at 15 ml. We performed three radiological examinations and calculated the volumes using the ellipsoid
formula d1 x d2 x d3 x π/6. Four morphologically different pouch types have been observed: regular, concentric, eccentric-medial
and eccentric-lateral. The ϕ-angle corresponds to the angle between the spinal column and the gastric band. Results: In the
first group, the pouch volume increased from 21.2 ml ± 21.2 to 87.9 ml ± 64.6 (p=0.006) and the BMI fell from 47.1 kg/m2 ± 8.4 to 38.1 kg/m2 ± 7.0 (p=0.001). The pouch volume of the second group increased from 10.4 ml ± 5.8 to 38.8 ml ± 29.1 (p<0.001), and the BMI
reduced from 48.4 kg/m2 ± 6.9 to 39.3 kg/m2 ± 6.7 (p<0.001). If the ϕ-angle is smaller than 4°,the pouch is of the eccentric-medial type. Conclusions: The transbursal
operative technique is responsible for the development of the eccentric-medial pouch. If the anterior sero-muscular fixative
sutures tear, an eccentric-lateral pouch results. All pouch types are affected by changes at the pouch-esophageal junction
and by pathological developments in the distal and middle oesophagus. |
| |
Keywords: | BARIATRIC SURGERY MORBID OBESITY LAPAROREPRINT SCOPIC ADJUSTABLE GASTRIC BANDING POUCH VOLUME POUCH DILATATION RADIOLOGY |
本文献已被 PubMed SpringerLink 等数据库收录! |
|