Centre for Obesity Research and Education (CORE), Monash University, The Alfred Hospital, Melbourne, Australia.
Obes Surg. 2010 Dec;20(12):1690-7. doi: 10.1007/s11695-010-0278-9.
The laparoscopic adjustable gastric band (LAGB) has previously been classified as a restrictive procedure; physically limiting meal size. Recently, the key mechanism has been hypothesized to be the induction of satiety without restriction. Effects can be controlled by modifying LAGB volume, possibly as a result of effects on gastric emptying or transit through the LAGB.
Successful LAGB patients underwent paired, double blinded, esophageal transit and gastric emptying scintigraphic studies; with the LAGB at optimal volume and near empty. A new technique allowed assessment of emptying and transit through the infra- and supraband compartments.
Fourteen of 17 patients completed both scans (six males; mean age, 48.9 ± 11.3 years, % excess weight loss 69.0 ± 15.2). At optimal volume a delay in transit of semi-solids into the infraband compartment was observed in ten patients vs. three when the LAGB was empty, (p = 0.01). The median retention of a meal in the supraband compartment immediately after cessation of intake was: empty 2.8% (2.3-7.9) vs. optimal 3.6% (1.7-4.5), (p = 0.57). Overall gastric emptying half time (minutes) was normal at both volumes: optimal 64.2 ± 29.8 vs. empty 95.2 ± 64.1, (p = 0.14). LAGB volume did not affect satiety before the scan: optimal 4.3 ± 1.9 vs. empty 4.0 ± 2.2, (p = 0.49), or 90 min later: optimal 6.1 ± 1.9 vs. empty 5.9 ± 1.4, (p = 0.68).
The optimally adjusted LAGB briefly delays semi-solid transit into the infraband stomach without physically restricting meal size. The supraband compartment is usually empty of an ingested meal 1-2 min after intake ceases and overall gastric emptying is not affected.
腹腔镜可调胃束带（LAGB）以前被归类为限制程序；物理上限制进餐量。最近，其关键机制被假设为诱导饱腹感而不限制。可以通过修改 LAGB 体积来控制效果，这可能是由于对胃排空或通过 LAGB 转运的影响。
成功的 LAGB 患者接受了配对的、双盲的、食管转运和胃排空闪烁照相研究；LAGB 的最佳体积和接近排空。一种新技术允许评估通过 infra- 和 supraband 隔室的排空和转运。
17 例患者中有 14 例完成了两次扫描（6 名男性；平均年龄 48.9 ± 11.3 岁，体重减轻百分比 69.0 ± 15.2）。在最佳体积下，10 例患者的半固体进入 infraband 隔室的转运延迟，而当 LAGB 排空时，3 例患者出现这种情况（p = 0.01）。摄入停止后，supraband 隔室内的膳食保留中位数：排空 2.8%（2.3-7.9）与最佳 3.6%（1.7-4.5），（p = 0.57）。在两种体积下，整体胃排空半衰期（分钟）均正常：最佳 64.2 ± 29.8 与排空 95.2 ± 64.1，（p = 0.14）。LAGB 体积在扫描前不会影响饱腹感：最佳 4.3 ± 1.9 与排空 4.0 ± 2.2，（p = 0.49），或 90 分钟后：最佳 6.1 ± 1.9 与排空 5.9 ± 1.4，（p = 0.68）。
最佳调整的 LAGB 可短暂延迟半固体进入 infraband 胃的转运，而不会物理上限制进餐量。supraband 隔室通常在摄入停止后 1-2 分钟内排空摄入的食物，整体胃排空不受影响。
