title: Adjustable gastric banding: assessment of safety and efficacy of bolus-filling during follow-up.
abstract: BACKGROUND
  Individual band-filling on demand of the morbidly obese patient is a major advantage of adjustable gastric banding. An increasing number of patients results in an enormous amount of outpatient follow-up visits, which inspired us to compare a stepwise band-filling strategy with a single bolus injection 4 weeks after the operative procedure.
  
  
  METHODS
  40 consecutive patients were prospectively randomized in 2 groups. 20 patients (Group A) had stepwise band-filling during 6 monthly ambulant visits. 20 patients (Group B) had a bolus-filling 4 weeks postoperatively and had the next follow-up after another 5 months. Weight loss, complications and procedural costs during follow-up were compared.
  
  
  RESULTS
  Patients of both groups did not differ in age, gender or preoperative BMI. There was no significant difference postoperatively in excess weight lost (EWL) after 9 months. Postoperative complications did not differ significantly. By means of bolus-filling, a 60% and 53% reduction in outpatient clinical work was achieved within the 6 and 9 months, respectively.
  
  
  CONCLUSIONS
  Postoperative management after gastric banding takes advantage of a single bolus-filling during the first postoperative 6 months due to sufficient weight loss, low complication rate but significant reduction of personal, financial and logistic efforts.
authors.affiliation: Department of General and Transplant Surgery, University Hospital, Anichstrasse 35, A-6020 Innsbruck, Austria.
authors.forename: W
authors.initials: W
authors.lastname: Kirchmayr
authors.forename: A
authors.initials: A
authors.lastname: Klaus
authors.forename: G
authors.initials: G
authors.lastname: Mühlmann
authors.forename: R
authors.initials: R
authors.lastname: Mittermair
authors.forename: H
authors.initials: H
authors.lastname: Bonatti
authors.forename: F
authors.initials: F
authors.lastname: Aigner
authors.forename: H
authors.initials: H
authors.lastname: Weiss
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000379:methods; D003365:Costs and Cost Analysis; D005260:Female; D015391:Gastroplasty / Q000191:economics / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D016896:Treatment Outcome