Adjustable gastric and esophagogastric banding. Is a pouch compulsory?

Abstract

Background: Pouch volume and stoma diameter are believed to have a significant impact on the efficacy of restrictive bariatric surgery. However, it is not clear whether the pouch is compulsory in stoma-adjustable gastric and esophagogastric banding. Methods: Between April 1997 and April 1998, we performed 26 esophagogastric and 109 gastric bandings using the Swedish Adjustable Gastric Band (SAGB). The patients were assigned to four groups defined according to the initial of the volume pouch (as determined radiologically): esophagogastric banding (no pouch), gastric banding <7.5 ml, gastric banding 7.5-15 ml, and gastric banding 15-30 ml. weight loss, increase in pouch volume, symptoms, and complications were recorded 6 and 12 months postoperatively. results: all but one patient achieved significant weight reduction; there were no significant differences among the study groups. increase in pouch volume was observed in 0-31.8% of patients. preexisting heartburn and regurgitation improved postoperatively in all groups, but dysphagia developed in the esophagogastric banding group postoperatively. two band migrations occurred in the esophagogastric banding group, and two pouch dilatations were observed in the gastric banding groups. conclusions: pouch volume is a negligible factor in terms of weight reduction and complications following adjustable esophagogastric or gastric banding. postoperative dysphagia represents a drawback of esophagogastric banding.