Pulmonary aspiration in adjustable gastric banding carriers undergoing a second surgical procedure.


COD: 2762_07_11_2017_AOP Categorie: , ,

Contardo Vergani, Marco Venturi, Sara Badiali, Barbara Chella, Enrico Mozzi

Ann Ital Chir, Digital Edition 2017, 6
Epub Ahead of Print – November 7

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BACKGROUND: The observation of a relatively high number of pulmonary aspirations (PA) among gastric band (GB)
carriers undergoing a second surgery, prompted us to modify our strategy for GB patients candidate to further operation
under general anesthesia.
MATERIAL OF STUDY AND RESULTS: In January 2013, following the occurrence of PA at the induction of general anesthesia
in 1 GB carrier undergoing a further operation, we reviewed our Data Base between January 2005 and 2013,
to explore the rate of pulmonary aspiration in patients GB carriers undergoing a second surgery. Considering the rate
(3/172 – 1.7%) too high in comparison with non-GB carriers, we decided to deflate the banding before any further
surgery planned under general anesthesia. We then retrospectively reviewed the occurrence of PA after having changed the
protocol. Since February 2013, through December 2016, 81 GB carriers underwent a second surgery and not a single
episode of PA occurred (0/81).
DISCUSSION:The occurrence of PA in patients with GB seems greater than in non-GB patients. Larger series should be
examined to assess the incidence of PA among this specific population. Awareness of the increased risk is important to
general anesthesiologists and surgeons, considering the increasing number of GB carriers who may be in need of surgery.
Our result after adopting the deflation policy, even though not statistically significant, seems highly suggestive.
CONCLUSION:We believe that, considering the potentially severe consequences of PA, the gastric band should be
deflated before any planned procedure requiring general anesthesia. Further data are needed.