ABSTRACT
BACKGROUND: In the last decade, laparoscopic surgery for morbid obesity has become widely employed, including a marked increase in the placement of adjustable gastric bands (AGB). Among the co-morbidities of morbid obesity is cholelithiasis. The question arises whether concomitant cholecystectomy increases the risk of postoperative infectious complications due to the association of a potentially contaminated procedure with a clean operation, placement of an AGB. The aim of this study is to evaluate the postoperative outcome in patients submitted to laparoscopic AGB with cholecystectomy. METHODS: From January 2000 to January 2004, 308 patients (85 men and 223 women) had AGB placed. BMI ranged from 38.9 to 65.6 kg/m(2) (mean 41.6). In 17 patients (5.5%), gallstones were detected by ultrasonography, and cholecystectomy was performed together with the AGB. Mean operative time for placement of the AGB was 58 +/- 18 min, and in those with cholecystectomy 86 +/- 17 min (P =0.20). RESULTS: All patients that had placement of AGB and cholecystectomy had satisfactory postoperative outcome. No infectious complications were observed. CONCLUSION: Laparoscopic cholecystectomy performed simultaneously with placement of an AGB has been a safe procedure.
Subject(s)
Cholecystectomy, Laparoscopic/methods , Cholelithiasis/surgery , Gastric Balloon , Gastroplasty/methods , Obesity, Morbid/surgery , Adolescent , Adult , Brazil , Cholecystectomy, Laparoscopic/adverse effects , Cholelithiasis/diagnosis , Cholelithiasis/epidemiology , Cohort Studies , Combined Modality Therapy , Comorbidity , Feasibility Studies , Female , Follow-Up Studies , Gastroplasty/adverse effects , Humans , Male , Middle Aged , Obesity, Morbid/diagnosis , Obesity, Morbid/epidemiology , Postoperative Complications/epidemiology , Probability , Risk Assessment , Severity of Illness Index , Treatment OutcomeABSTRACT
BACKGROUND: About 15% of patients who undergo adjustable gastric banding (AGB) have difficulty losing weight due to, among other factors, the development or maintenance of binge eating disorder. Topiramate is an anticonvulsive drug with proven good results in controlling binge eating episodes. The objective of this study was to analyze the effect of topiramate in patients with AGB. METHODS: 16 patients with binge eating and inadequate weight loss after AGB were analyzed prospectively for 3 months while receiving topiramate in doses varying from 12.5 to 50 mg per day. RESULTS: There was a mean increase in excess weight loss from 20.4% to 34.1% without the need for band readjustment. 2 patients had intolerance to topiramate and were changed to fluoxetine 40 mg per day. CONCLUSION: Topiramate may be a useful adjuvant for patients with AGB and binge eating disorder.
