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KMID : 1033120130020020039
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대한비만대사외과학회지
2013 Volume.2 No. 2 p.39 ~ p.44
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Personal Experience of Fluoroscopy-assisted Bolus Type Adjustment after Laparoscopic Adjustable Gastric Banding
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Lee Ki-Woon
Kim Seong-Min
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Abstract
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Purpose: Little data exist regarding the ideal filling protocol for band adjustment after placement of laparoscopic adjustable gastric bands. The authors investigated the effect of initial postoperative band adjustment under fluoroscopic guidance.
Materials and Methods: Three initial band adjustments were performed under fluoroscopic guidance with adjustment of the stoma diameter to 3-4 mm. Subsequent minor band adjustments were performed only after clinical interview except unusual situations.
Results: A total of 100 patients were included in this study. The group of patients included 90 women and 10 men, whose mean age at surgery was 32.6±8.4 years. The mean preoperative BMI was 34.8±6.3 kg/m2. The final filling volume in large bands at each adjustment was 4.6±1.1 cc, 6.1±1.2 cc, and 6.9±1.4 cc, respectively, and in small bands, 1.7±0.4 cc, 2.6±0.4 cc, and 3.2±0.5 cc, respectively. Percentage of excess weight loss (%EWL) in this series of patients was 17.1±11.4, 42.0±23.2, 63.3±26.3, and 83.9±26.7 at 1, 3, 6, and 12 postoperative months. Adverse reactions to band adjustment were observed in six patients; stoma obstruction (n=1), band slippage (n=3), symmetric pouch dilatation (n=1), and band erosion (n=1).
Conclusion: According to our preliminary results, initial band adjustments with adjustment of stoma diameter to 3-4 mm under fluoroscopic guidance resulted in greater weight loss within the first postoperative year, during which most weight reduction after gastric banding surgery occurs.
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KEYWORD
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Laparoscopic adjustable gastric band (LAGB), Band adjustment, Fluoroscopy, Bariatric surgery, Stoma diameter
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