Obesity Surgery

, Volume 19, Issue 7, pp 850–855 | Cite as

Weight Loss After Gastric Banding is Associated with Pouch Pressure and not Pouch Emptying Rate

  • Jan Bech Pedersen
  • Jens Fromholt Larsen
  • Asbjørn Mohr Drewes
  • Anne Arveschoug
  • Jens Peter Kroustrup
  • Hans GregersenEmail author
Clinical Research



Morbid obesity defined as BMI > 40 is a growing problem. It is primarily treated with diet, lifestyle changes, and medicine. However, at present, surgery remains the only effective option for the management.


Seventeen patients were studied 2 months after laparoscopic gastric banding. The aims were to evaluate the association between (1) the extent of pouch filling and satiety, (2) gastric emptying and weight loss, and (3) the pouch pressure during a meal and the sensation of satiety and weight loss.


The preoperative weight was 146 kg (range 108–202 kg). The average weight loss was 21 kg between the banding and the examination. The half time (T50%) for the pouch emptying was 3 min (quartiles 3–12.5) and the time to 90% of pouch emptying (T90%) was 40 min (24.5–60). The sensation of satiety lasted 75 min (57.5–105), and the feeling of hunger started after 90 min (40–90). Neither T50% nor T90% correlated to the weight loss (R = 0.006, P > 0.5 and R = 0.1, P > 0.5). The sensation of satiety did not correlate to T50% or T90% (R = 0.6, P = 0.12 and R = 0.5, P = 0.15). No association was found between the sensory data and the pressure decline. Significant association was found between the load of the meal expressed as the area under the pouch pressure curve and the weight loss (R = 0.786, P = 0.015).


The satiety sensation lasted much longer than the pouch emptying and the pressure increase. The pressure load correlated to the weight loss. This indicates that neuroendocrine mechanisms caused by the accumulated mechanical load are most important for maintaining satiety.


Gastric banding Satiety Pressure load Pouch emptying 



There is no any commercial interest in the subject of study and the source of any financial or material support.


  1. 1.
    Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery. A systemic review and meta-analysis. JAMA. 2004;292:1724–37.CrossRefGoogle Scholar
  2. 2.
    Sjöström L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351:2683–93.CrossRefGoogle Scholar
  3. 3.
    Steinbrook R. Surgery for severe obesity. N Engl J Med. 2004;350:1075–9.CrossRefGoogle Scholar
  4. 4.
    Chapman AE, Kiroff G, Game P, et al. Laparoscopic adjustable gastric banding in the treatment of obesity: a systematic literature review. Surgery 2004;135:326–51.CrossRefGoogle Scholar
  5. 5.
    Mistiaen W, Vaneerdeweg W, Blockx P, et al. Gastric emptying rate measurement after vertical banded gastroplasty. Obes Surg. 2000;10:245–9.CrossRefGoogle Scholar
  6. 6.
    Näslund I. The size of the gastric outlet and the outcome of surgery for obesity. Acta Chir Scand. 1986;152:205–10.PubMedGoogle Scholar
  7. 7.
    Näslund I. Gastric bypass versus gastroplasty. A prospective study of differences in two surgical procedures for morbid obesity. Acta Chir Scand Suppl. 1987;536:1–60.PubMedGoogle Scholar
  8. 8.
    Andersen T, Pedersen BH. Pouch volume, stoma diameter, and clinical outcome after gastroplasty for morbid obesity. A prospective study. Scand J Gastroenterol. 1984;19:643–9.CrossRefGoogle Scholar
  9. 9.
    Andersen T, Højlund Pedersen B, Dissing I, et al. A randomized comparison of horizontal and vertical banded gastroplasty: What determines weight loss. Scand J Gastroenterol. 1989;24:186–92.CrossRefGoogle Scholar
  10. 10.
    Larsen JF, Kroustrup JP. Laparoscopic adjustable gastric banding for the treatment of morbid obesity. Six years’ experiences. Ugeskr Læger. 2005;167:1946–9.PubMedGoogle Scholar
  11. 11.
    Gregersen H. Biomechanics of the gastrointestinal tract. London: Springer Verlag; 2002.Google Scholar
  12. 12.
    Barlow JD, Gregersen H, Thompson DG. Identification of biomechanical factors associated with the perception of distension in the human oesophagus. Am J Physiol. 2002;282:G683–89.Google Scholar
  13. 13.
    Pedersen J, Gao C, Egekvist H, et al. Pain and biomechanical responses to distention of the duodenum in patients with systemic sclerosis. Gastroenterology. 2003;124:1230–9.CrossRefGoogle Scholar
  14. 14.
    Drewes AM, Pedersen J, Weiming L, et al. Controlled mechanical distension of the human oesophagus: Sensory and biomechanical findings. Scand J Gastroenterol. 2003;38:27–35.CrossRefGoogle Scholar
  15. 15.
    Gregersen H, Emery J, McCulloch AD. History-dependent mechanical behaviour of the guinea-pig small intestine. Ann Biomed Eng. 1998;26:1–9.CrossRefGoogle Scholar
  16. 16.
    Ray EC, Nickels MW, Sayeed S, et al. Predicting success after gastric bypass: the role of psychosocial and behavioral factors. Surgery. 2003;134:555–63.CrossRefGoogle Scholar
  17. 17.
    Näslund E, Hellstrom PM, Kral JG. The gut and food intake: an update for surgeons. J Gastrointest Surg. 2001;5:556–67.CrossRefGoogle Scholar
  18. 18.
    Murphy KG, Bloom SR. Gut hormones in the control of appetite. Exp Physiol. 2004;89:507–16.CrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media, LLC 2009

Authors and Affiliations

  • Jan Bech Pedersen
    • 1
    • 2
  • Jens Fromholt Larsen
    • 2
  • Asbjørn Mohr Drewes
    • 1
    • 3
  • Anne Arveschoug
    • 4
  • Jens Peter Kroustrup
    • 5
  • Hans Gregersen
    • 1
    • 2
    • 6
    Email author
  1. 1.Mech-SenseAalborg Hospital Science and Innovation CenterAalborgDenmark
  2. 2.Surgical Gastroenterology, Aarborg HospitalAarhus University HospitalAalborgDenmark
  3. 3.Gastroenterology, Aarborg HospitalAarhus University HospitalAalborgDenmark
  4. 4.Clinical Physiology, Aalborg HospitalAarhus University HospitalAalborgDenmark
  5. 5.Endocrinology, Aalborg HospitalAarhus University HospitalAalborgDenmark
  6. 6.Aalborg Hospital Science and Innovation CenterAalborgDenmark

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