Poole Norman, Al Atar Ashraf, Bidlake Louise, Fienness Alberic, McCluskey Sara, Nussey S, Bano Gal, Morgan John
Department of Mental Health, St. George's Hospital and Medical School, London, U.K.
Obes Surg. 2004 Jun-Jul;14(6):798-801. doi: 10.1381/0960892041590827.
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.
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.
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.
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.
腹腔镜可调节胃束带术越来越多地用于病态肥胖个体以实现减重。一些患者术后出现胃囊扩张这一并发症，限制了该手术的效用。手术变量对这一并发症的预测能力较差。在某单中心接受腹腔镜可调节胃束带术的157例患者中有5例出现了这种情况。
对精神病学和外科病历进行回顾性分析，以确定是否存在符合操作定义的精神障碍，并与来自同一人群的10名对照者进行比较。
病例组更有可能有过去或当前的暴饮暴食、情绪引发的进食且对两者关联的意识降低、情感障碍病史、性功能减退以及术前成功减重。在服用奥利司他的依从性、童年期性虐待、与父母的关系、神经性贪食症病史、束带充气速率或术前体重指数方面，两组之间未观察到差异。
心理因素可能比生物医学变量更能预测胃囊扩张。饮食失调可能是调节负面情绪的一种尝试。胃囊扩张可能是这种饮食行为的一个后果。
