Annals of Surgery

Skip Navigation LinksHome > March 2013 - Volume 257 - Issue 3 > Risk of Gastric Pouch Enlargement With Adjustable Gastric Ba...
Annals of Surgery:
doi: 10.1097/SLA.0b013e3182504665
Original Articles

Risk of Gastric Pouch Enlargement With Adjustable Gastric Banding in Premenopausal Women: Sex Hormones May Play a Role

Dixon, John B. MBBS, PhD*; Cobourn, Christopher S. MD

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Abstract

Objective: To examine the influence of age and gender on the development of proximal gastric pouch distension (PPD) after laparoscopic adjustable gastric banding (LAGB) surgery.

Background: PPD is the most common reason for revision with adjustable gastric banding surgery. Maintaining the anatomical integrity of bariatric surgery is a key to long-term success. It is therefore important to understand risk factors for complications.

Methods: We extracted details of 3000 consecutive individuals who underwent primary LAGB procedures at a single center between February 2005 and May 2011. Contemporaneous details of all complications were recorded in a database. The characteristics of those that subsequently required revision surgery for PPD were assessed and compared with those that did not.

Results: There were 132 cases for PPD requiring surgical intervention before September 2011. Incident PPD occurred in 5.1% and 1.3% of women and men, respectively. The mean age of those with PPD was 39.9 ± 9.25 compared with 43.9 ± 11.0 for those without it. The age and gender effects were independent, and the age effect was restricted to women. The adjusted odds ratios were 0.971 (95% CI [confidence interval], 0.954–0.986, P < 0.001) for age and 0.26 (95% CI, 0.12–0.56, P = 0.001) for male gender and younger women were more likely to have asymmetrical distension.

Conclusions: Younger women are at higher risk of PPD after LAGB surgery than men and women older than 50 years. Sex hormones may play a role in predisposing to gastric stretch after surgery. These findings may apply more broadly to the gastric “restrictive” component of other bariatric procedures.

© 2013 Lippincott Williams & Wilkins, Inc.

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