Micheletto Giancarlo, Roviaro Giancarlo, Lattuada Ezio, Zappa Marco Antonio, Mozzi Enrico, Perrini Massimo, Lanni Marco, Francese Massimo, Librenti Maria Cristina, Doldi Santo Bressani
Dipartimento di Scienze Chirurgiche, Università di Milano.
Ann Ital Chir. 2006 Sep-Oct;77(5):397-400.
The adjustable gastric banding is considered the most common procedure in Europe for the treatment of morbid obesity. We report our experience with this procedure, that was introduced in our Departments of Surgery since 1993.
From December 1993 to December 2004, 684 morbid obese patients (139 males and 545 females) underwent adjustable gastric banding (AGB) in our departments of Surgery. The first 323 patients were operated with perigastric procedure, the following 361 patients with pars flaccida technique. 601 patients were operated with laparoscopic approach, 83 with open approach. The average follow-up is 5 years.
Mean BMI decreased from 42.2 to 34 Kg/m2 five years after the operation, with an EWL of 54 %. The main early complications were: intraoperative gastric perforation (5 patients, 1 of which repaired in laparoscopy); hemorrhage from short gastric vessels (3 patient, repaired in laparotomy). The major late complications were: intragastric band migration (7 patients); irreversible dilatation of the gastric pouch (42 patients, treated surgically with band removal or repositioning).
In our experience laparoscopic adjustable gastric banding is a safe and effective procedure, suitable to most patients, and should be considered as the first choice in the surgical treatment of morbid obesity.
可调节胃束带术被认为是欧洲治疗病态肥胖最常用的手术方法。我们报告自1993年在我们的外科科室引入该手术后的经验。
从1993年12月至2004年12月，我们外科科室的684例病态肥胖患者（139例男性和545例女性）接受了可调节胃束带术（AGB）。前323例患者采用胃周手术，后361例患者采用松弛部技术。601例患者采用腹腔镜手术，83例采用开放手术。平均随访时间为5年。
术后5年，平均体重指数从42.2降至34 Kg/m²，多余体重减少率为54%。主要的早期并发症为：术中胃穿孔（5例患者，其中1例在腹腔镜下修复）；胃短血管出血（3例患者，在剖腹手术中修复）。主要的晚期并发症为：胃内束带移位（7例患者）；胃囊不可逆扩张（42例患者，通过手术取出束带或重新定位进行治疗）。
根据我们的经验，腹腔镜可调节胃束带术是一种安全有效的手术方法，适用于大多数患者，应被视为病态肥胖外科治疗的首选方法。
