Deitel M, Jones B A, Petrov I, Wlodarczyk S R, Basi S
Can J Surg. 1986 Sep;29(5):322-4.
The authors describe their experience with vertical banded gastroplasty in 233 patients for whom the follow-up ranged from 12 to 30 months. There were no deaths. Intraoperatively, two gastric perforations and one esophageal perforation occurred; these were closed and drained. A postoperative leak was treated promptly by removal of the collar, drainage and gastrostomy. There were three instances of late obstruction, due in one to mesh adhering to liver and in two to stenoses; gastrogastrostomy was followed by regained weight. Removal of the collar was also associated with failure to lose adequate weight. Rare complications were intraluminal erosion of mesh and staple-line breakdown. The gallbladder was still present in 175 patients; of these, 25 had gallstones and underwent a cholecystectomy at the time of gastroplasty. Of the other 150, symptomatic gallstones subsequently developed in 13. At 12 months after gastroplasty 80% of patients had lost at least 50% of excess weight and at 24 months 83% had lost 50% or more of excess weight (15 patients lost to follow-up). To avoid failures, the collar circumference should not be more than 5.0 cm. A small experience suggests that revision of a failed horizontal gastroplasty to vertical banded gastroplasty is hazardous.
作者描述了他们对233例接受垂直束带胃成形术患者的治疗经验，随访时间为12至30个月。无死亡病例。术中发生2例胃穿孔和1例食管穿孔，均进行了缝合和引流。术后漏液通过拆除束带、引流和胃造口术及时处理。有3例晚期梗阻，1例是由于网片粘连肝脏，2例是由于狭窄；胃胃吻合术后体重恢复。拆除束带也与未能减轻足够体重有关。罕见并发症为网片腔内侵蚀和吻合钉线破裂。175例患者胆囊仍存在；其中25例有胆结石，在胃成形术时接受了胆囊切除术。另外150例中，13例随后出现有症状胆结石。胃成形术后12个月，80%的患者至少减轻了50%的超重体重，24个月时83%的患者减轻了50%或更多的超重体重（15例失访）。为避免手术失败，束带周长不应超过5.0厘米。一项小样本经验表明，将失败的水平胃成形术改为垂直束带胃成形术具有危险性。
