Adjustable gastric banding: assessment of safety and efficacy of bolus-filling during follow-up.
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.
Kirchmayr
W
W
Department of General and Transplant Surgery, University Hospital, Anichstrasse 35, A-6020 Innsbruck, Austria.
Klaus
A
A
Mühlmann
G
G
Mittermair
R
R
Bonatti
H
H
Aigner
F
F
Weiss
H
H
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