Document Detail


Effect of laparoscopic gastric banding on esophageal motility.
MedLine Citation:
PMID:  16417759     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Alterations in esophageal motility may occur after placement of an adjustable gastric band as treatment for morbid obesity, near the gastro-esophageal junction. It causes an outlet obstruction, especially during follow-up after the band is filled. METHODS: 29 morbidly obese patients underwent conventional manometry preoperatively, 6 weeks postoperatively before and after filling the band and at 6 months postoperatively. A questionnaire was used to assess upper gastrointestinal symptoms during follow-up. RESULTS: After band placement, there was a significant increase in lower esophageal sphincter (LES) end-expiratory pressure at 6 weeks with an empty band: 1.3 (0.9-1.9) kPa (median (interquartile range) (P=0.003), 6 weeks with a filled band: 2.1 (1.5-2.8) kPa (P=0.0001), and at 6 months: 1.5 (1.3-1.9) kPa (P=0.001), compared to the preoperative pressure: 0.8 (0.6-1.3) kPa. Also after band placement, the high pressure zone length increased (preop 5.0 (4.3-6.0) cm vs 6 weeks 6.0 (5.0-6.5) cm (P=0.003). The propagation of peristaltic contractions was not significantly altered after band placement. Heartburn decreased 6 weeks postoperatively (P=0.04) but increased at 6 months. Heartburn at 6 months was correlated with pouch formation (0.667; P<0.01). CONCLUSION: Adjustable gastric band placement causes an increase in LES pressure and length of the high pressure zone. It decreases reflux symptoms in the short-term, but this effect appears not to be related to an effect on LES pressure or length. Pouch formation increases reflux symptoms without having any relationship to LES pressure and length. Band placement in the short-term does not disturb propagation of esophageal contractions.
Authors:
J R de Jong; B van Ramshorst; R Timmer; H G Gooszen; A J P M Smout
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obesity surgery     Volume:  16     ISSN:  0960-8923     ISO Abbreviation:  Obes Surg     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-01-18     Completed Date:  2006-04-25     Revised Date:  2007-12-05    
Medline Journal Info:
Nlm Unique ID:  9106714     Medline TA:  Obes Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  52-8     Citation Subset:  IM    
Affiliation:
Department of Surgery, University Medical Centre, Utrecht, and Department of Surgery, St Antonius Hospital, Nieuwegein, The Netherlands. jr.djong@hccnet.nl
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MeSH Terms
Descriptor/Qualifier:
Adult
Esophageal Motility Disorders / etiology*
Esophageal Sphincter, Lower*
Esophagogastric Junction*
Female
Follow-Up Studies
Gastroplasty / adverse effects*
Humans
Laparoscopy
Male
Middle Aged
Obesity, Morbid
Prospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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