Pouch dilatation following laparoscopic adjustable gastric banding: psychobehavioral factors (can psychiatrists predict pouch dilatation?).
BACKGROUND
Laparoscopic adjustable gastric banding is increasingly being performed in morbidly obese individuals for weight loss. Some patients develop pouch dilatation as a postoperative complication that limits the utility of the procedure. Surgical variables are poor predictors of this complication. 5 patients from a series of 157 who underwent LAGB at a single center developed the condition.


METHODS
Psychiatric and surgical case-notes were analyzed retrospectively for the presence of operationally defined psychiatric disorders and compared to 10 controls from the same population.


RESULTS
Cases were significantly more likely to have past or current binge eating, emotionally triggered eating with reduced awareness of the link, a history of affective disorder, reduced sexual functioning and successful preoperative weight loss. No difference between groups was observed for compliance with orlistat, childhood sexual abuse, relationships with parents, history of bulimia nervosa, rate of band inflation or preoperative BMI.


CONCLUSIONS
Psychological factors may be better predictors of pouch dilatation than biomedical variables. Disordered eating can be an attempt to modulate negative emotions. Pouch dilatation may be a consequence of this eating behavior.
Department of Mental Health, St. George's Hospital and Medical School, London, U.K.
Norman
N
Poole
Ashraf
A
Al Atar
Louise
L
Bidlake
Alberic
A
Fienness
Sara
S
McCluskey
S
S
Nussey
Gal
G
Bano
John
J
Morgan
D000328:Adult; D015897:Comorbidity; D004108:Dilatation, Pathologic; D001068:Feeding and Eating Disorders / Q000453:epidemiology*; D005260:Female; D015391:Gastroplasty / Q000009:adverse effects* / Q000523:psychology*; D006801:Humans; D010535:Laparoscopy; D009767:Obesity, Morbid / Q000453:epidemiology*; D012189:Retrospective Studies