DOES THE SIZE OF THE UPPER POUCH AFFECT WEIGHT-LOSS AFTER VERTICAL BANDED GASTROPLASTY

Background: The importance of creating a small 10-20 ml upper pouch wh en performing a vertical banded gastroplasty (VBG) is often stated in the literature. In order to test the hypothesis that weight loss is su perior in patients with a small upper pouch, we examined the weight lo ss curves for three different pouch sizes in our patients operated wit h VBG. Method: Retrospective analysis of patients operated with VBG at our institution between November 1986 and April 1994 was done. A modi fied Mason VBG was performed with intraoperative balloon measurements of the size of the upper pouch. Three groups were identified according to different pouch volumes: 20 ml (n = 65), 30 ml(n = 46), and less t han or equal to 40 ml(n = 47). Results: Of the 198 patients operated w ith VBG, pouch volume measurement was successful in 158 patients. Mean pouch volume was 32 ml at 50.5 cm of water. Loss of body mass index a t 6, 12, 24, 48, 60 months did not significantly differ in the three g roups. The rate of late reoperative procedures was also similar In the three groups. The incidence of staple-line breakdown (SLB) and endosc opically verified oesophagitis was higher in the greater than or equal to 40 ml group.