Archive for the 'Laparoscopic gastric banding' Category

26 Jul

Changes in gallbladder motility and gallstone formation following laparoscopic gastric banding: CONCLUSIONS

We have demonstrated that morbidly obese patients have an enlarged fasting gallbladder volume, rather normal gallbladder emptying for its size, increased gallbladder residual volume and a high refilling rate. The weight loss that follows laparoscopic gastric banding surgery, particularly if excessively rapid, results in impaired gallbladder emptying, accompanied by an increase in gallbladder residual volume […]

25 Jul

Changes in gallbladder motility and gallstone formation following laparoscopic gastric banding: DISCUSSION (Part 5)

Gastric banding restricts food intake and hence leads to weight loss. Factors such as meal frequency, total calories consumed and calories as fat all influence gallbladder emptying through the release of CCK. This in turn affects the enterohepatic cycling of bile salts and hence, biliary lipid composition. The standard dose of CCK-8 given to quantitated […]

24 Jul

Changes in gallbladder motility and gallstone formation following laparoscopic gastric banding: DISCUSSION (Part 4)

The advantages of laparascopic gastric banding include a shortened hospitalization and a quicker return to normal oral intake and activity after surgery. The preservation of the normal anatomy of the gastrointestinal tract and of the entero-hepatic circulation of bile salts should lessen the predisposition towards gallstone formation. Bile salts secretion is the driving force for […]

23 Jul

Changes in gallbladder motility and gallstone formation following laparoscopic gastric banding: DISCUSSION (Part 3)

The high refilling rate of the gallbladder may reflect a high rate of hepatic bile secretion – these large individuals empty a large bolus of bile salts into the small intestine that recycles via the enterohepatic circulation – and a relatively low intravesicular pressure (P) (from LaPlace’s law [P a 2T/r], the large gallbladder residual […]

22 Jul

Changes in gallbladder motility and gallstone formation following laparoscopic gastric banding: DISCUSSION (Part 2)

The current study did not demonstrate any differences between the male and female volunteers in their gallbladder motility in terms of emptying, refilling or gallbladder volume. A sex difference in the incidence of gallstones exists between men and women, but this is not linked to any proposed difference in gallbladder motility caused by the female […]

21 Jul

Changes in gallbladder motility and gallstone formation following laparoscopic gastric banding: DISCUSSION (Part 1)

Of the three patients who developed gallstones at six weeks, one required a cholecystectomy. Another still had stones at six months but had no symptoms. In the third patient, the gallstones disappeared and were not evident even on repeat ultrasonography. This latter patient exhibited an improved gallbladder emptying from 56.4% to 67.1%, while weight loss […]

20 Jul

Changes in gallbladder motility and gallstone formation following laparoscopic gastric banding: RESULTS (Part 4)

The three patients who developed stones all had a weight loss of greater than 1.7% (1.73, 2.01 and 2.33%, respectively, for each) of their total body weight per week over the six weeks. None were diabetic. Indeed, two out of the three patients were above the 95 percentile (mean ±2SD) of weight loss for this […]

19 Jul

Changes in gallbladder motility and gallstone formation following laparoscopic gastric banding: RESULTS (Part 3)

Obese patients six weeks after surgery Of the 14 patients enrolled at the beginning of this study, three developed gallstones, while three others elected not to continue in the study. The BMI decreased in the remaining 11 patients from 44.5±3.2 to 40.4±2.8 (or 1.4±0.1% body weight per week), from that recorded preoperative ly compared with […]

18 Jul

Changes in gallbladder motility and gallstone formation following laparoscopic gastric banding: RESULTS (Part 2)

Table 2 provides the age, sex and BMI of both the volunteers and the obese patients. There was no difference in age between the controls (volunteers) and the obese group. No effort was made to match the sex distribution in the obese group because women predominantly sought this type of surgery. Gallbladder volumes after an […]

17 Jul

Changes in gallbladder motility and gallstone formation following laparoscopic gastric banding: RESULTS (Part 1)

Statistical analysis The statistics program SPSS (10 Edition SPSS Inc, USA) was used to perform an analysis of variance (ANOVA). The Bonferroni correction or the nonparametric Mann-Whitney analysis were used where appropriate. A P<0.05 was accepted as significant.

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