Alessandra Dorigo, Abstract Co-Author: Nothing to Disclose

Massimo Zilocchi MD, Presenter: Nothing to Disclose

Ezio Lattuada, Abstract Co-Author: Nothing to Disclose

Enrico Mozzi, Abstract Co-Author: Nothing to Disclose

Marco Antonio Zappa, Abstract Co-Author: Nothing to Disclose

Daniele Riccardo Meregaglia, Abstract Co-Author: Nothing to Disclose

Giancarlo Roviaro, Abstract Co-Author: Nothing to Disclose

Pietro R. Biondetti MD, Abstract Co-Author: Nothing to Disclose

LAGB is the most commonly performed operation for treatment of morbid obesity. Patients usually undergo follow-up to adjust the band volume under radiological or clinical guidance. Since 2005 we plan a specific day-hospital (DH) which include a multi-specialistic evaluation (surgical, radiological, dietetics and psychological) to optimize weight loss and detect complications. The aim of our study was to evaluate if the introduction of the radiological control in a multi-specialized follow-up allowed better results in term of weight loss and early identification of complication, decreasing the risk of re-intervention.

Two groups of patients were considered: A) patients operated from 2000 to 2003; B) patients operated from 2006 to 2008. Group A underwent follow-up without a defined schedule, according to individual needs. Group B underwent DH at 3 months, 6 months and 1 year after surgery, then annually. We reviewed the follow-up of both groups over a period of 2 years to assess the clinical outcome, expressed as percentage excess body weight loss (%EWL), and to evaluate the number and radiological features of late complications of LAGB.

After review and exclusions we found 209 patients in group A (43 males and 166 females, mean age 42 ± 13 years and mean BMI 38.8 ± 1.8) and 229 patients in group B (57 males and 172 females, mean age 30 ± 9 years and mean BMI 50.0 ± 6.6). After 24 months the mean BMI and mean % EWL were respectively 36 ± 0.0 and 15.4% ± 9% for the group A and 40 ± 6.2 and of 41.9 % ± 18.5% for the group B. We identified 81 late complications in group A (38,7 %) and 50 in group B (21,8%) which led to reoperation in 16,7 % and 13,5 % of the patients of group A and B respectively. Pouch dilatation and anterior band slippage were the commonest cause of reoperations (42,9% in group A, 40 % in group B), followed by band migration (11,4 % in group A and 4% in group B).

Band-volume adjustment under radiological guidance, as part of a multi-specialistic DH, reveals a better outcome in term of weight loss. It offers significant advantages related to the calibration of the stoma diameter and allows an early detection of complicatons, reducing the number of reoperations.

LAGB is a safe method for the treatment of morbid obesity, however is recommended a multi-specialist follow-up with band volume adjustment under radiological control to improve clinical results.

Dorigo, A, Zilocchi, M, Lattuada, E, Mozzi, E, Zappa, M, Meregaglia, D, Roviaro, G, Biondetti, P, Band Volume Adjustment under Radiological and Clinical Control Following Laparoscopic Adjustable Gastric Banding (LAGB).  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11004842.html