Dixon John B, O'Brien Paul E
Australian Centre for Obesity Research and Education, Monash Medical School, The Alfred Hospital, Melbourne, Australia.
Obes Surg. 2005 May;15(5):624-9. doi: 10.1381/0960892053923897.
The single most important attribute of the laparoscopic adjustable gastric band (LAGB) is its adjustability. Having the correct volume of fluid within the band is crucial for optimal performance. We observe a small reduction of the satiety-promoting effect with time. The characteristics and clinical relevance of volume change have not been adequately investigated.
One observer measured the saline volume within the 10-cm Lap-Band in 118 consecutive patients who fulfilled the entry criteria. The same observer had performed and recorded the previous adjustment. Initial volume, final volume and time between observations provide the data for analysis. In addition, a range of adjustable gastric bands currently available were bench-tested to assess broad applicability of findings.
The difference between observations varied from 0.0 ml to -1.0 ml, median of -0.1 interquartile range (IQR) 0.0-0.2 ml. Two factors were associated with volume change: time in days between the observations (r = -0.55, P<0.001) and the initial volume within the band system (r = -0.50, P<0.001). These two independent factors accounted for a significant proportion of the variance observed (Cox and Snell R2 = 0.45, P<0.001). Replacement of any discrepancy appears to maintain effectiveness. All six bands showed similar saline loss when bench-tested.
Adjustable gastric bands are semipermeable, leading to a small reduction in saline volume with time. Patients should be informed of this effect, attend for regular follow-up visits and seek help if the band's effectiveness appears reduced. We recommend that the volume present should be checked and readjusted at least every 6 months.
腹腔镜可调节胃束带（LAGB）最重要的特性是其可调节性。束带内保持正确的液体量对于最佳性能至关重要。我们观察到随着时间的推移，促饱腹感的效果会有小幅下降。液体量变化的特征及临床相关性尚未得到充分研究。
一名观察者对118例符合入选标准的连续患者，测量了10厘米Lap-Band内的盐水量。该观察者曾进行并记录过之前的调整。初始液体量、最终液体量以及观察之间的时间提供了分析数据。此外，对目前可用的一系列可调节胃束带进行了台架测试，以评估研究结果的广泛适用性。
观察之间的差异从0.0毫升至 -1.0毫升不等，中位数为 -0.1，四分位间距（IQR）为0.0 - 0.2毫升。有两个因素与液体量变化相关：观察之间的天数（r = -0.55，P < 0.001）以及束带系统内的初始液体量（r = -0.50，P < 0.001）。这两个独立因素占观察到的方差的很大比例（Cox和Snell R2 = 0.45，P < 0.001）。弥补任何差异似乎都能维持有效性。在台架测试中，所有六种束带的盐水损失情况相似。
可调节胃束带具有半渗透性，导致盐水量随时间有小幅减少。应告知患者这一效应，让他们定期复诊，如果束带效果似乎降低应寻求帮助。我们建议至少每6个月检查并重新调整束带内的液体量。
