title: Postoperative management of laparoscopic gastric banding.
abstract: BACKGROUND
  The authors investigated the postoperative management of morbidly obese patients treated by laparoscopic adjustable gastric banding (LAGB) with the Lap-Band System.
  
  
  METHODS
  The 3-year postoperative band management is presented in 379 morbidly obese patients, divided according to intra-operative band filling and quartiles of maximum postoperative band filling.
  
  
  RESULTS
  LAGB resulted in a 40.8 +/- 24.5 percent excess weight loss (%EWL). Stoma stenosis occurred in 87 patients (23.0%), pouch dilatation in 52 (13.7%) and esophageal dilatation in 22 (5.8%). Most band-related complications were controlled by simple band deflation. The mean number of postoperative band adjustments was 2.3 +/- 1.7, and mean maximum band filling after surgery was 2.8 +/- 1.2 ml. Weight loss at 3 years was identical in 205 patients who had the band completely unfilled at surgery and in 174 patients who had the band filled with 1 to 3 ml of sterile saline. The rate of band-related complications was significantly lower in the first group. No differences in %EWL were observed between quartiles of maximum band filling after surgery. The rate of band-related complications increased with increasing levels of postoperative maximum band filling. In patients with the band filled with < 3.0 ml of sterile saline at 6 months, the inflation of further saline produced a dose-related increase in the rate of weight loss. In patients with the band filled with > 3.0 ml of sterile saline at 6 months, the inflation of further saline was associated with a reduced %EWL.
  
  
  CONCLUSIONS
  Postoperative adjustability of the Lap-Band was useful in the treatment of band-related complications and was able to significantly influence the rate of weight loss. On the other hand, aggressive postoperative band filling was associated with an increased rate of complications.
authors.affiliation: Obesity Unit, Department of Medical and Surgical Sciences, University of Padova, Padova, Italy. luca.busetto@unipd.it
authors.forename: Luca
authors.initials: L
authors.lastname: Busetto
authors.forename: Gianni
authors.initials: G
authors.lastname: Segato
authors.forename: Francesco
authors.initials: F
authors.lastname: De Marchi
authors.forename: Mirto
authors.initials: M
authors.lastname: Foletto
authors.forename: Maurizio
authors.initials: M
authors.lastname: De Luca
authors.forename: Franco
authors.initials: F
authors.lastname: Favretti
authors.forename: Giuliano
authors.initials: G
authors.lastname: Enzi
mesh_terms: D000328:Adult; D015897:Comorbidity; D005260:Female; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D008297:Male; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery; D011182:Postoperative Care; D015431:Weight Loss