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Gastric banding interferes with esophageal motility and gastroesophageal reflux.
Arch Surg 2005; 140(7):639-43AS

Abstract

BACKGROUND

Gastroesophageal reflux and progressive esophageal dilatation can develop after gastric banding (GB).

HYPOTHESIS

Gastric banding may interfere with esophageal motility, enhance reflux, or promote esophageal dilatation.

DESIGN

Before-after trial in patients undergoing GB.

SETTING

University teaching hospital.

PATIENTS AND METHODS

Between January 1999 and August 2002, 43 patients undergoing laparoscopic GB for morbid obesity underwent upper gastrointestinal endoscopy, 24-hour pH monitoring, and stationary esophageal manometry before GB and between 6 and 18 months postoperatively.

MAIN OUTCOME MEASURES

Reflux symptoms, endoscopic esophagitis, pressures measured at manometry, esophageal acid exposure.

RESULTS

There was no difference in the prevalence of reflux symptoms or esophagitis before and after GB. The lower esophageal sphincter was unaffected by surgery, but contractions in the lower esophagus weakened after GB, in correlation with preoperative values. There was a trend toward more postoperative nonspecific motility disorders. Esophageal acid exposure tended to decrease after GB, with fewer reflux episodes. A few patients developed massive postoperative reflux. There was no clear correlation between preoperative testing and postoperative esophageal acid exposure, although patients with abnormal preoperative acid exposure tended to maintain high values after GB.

CONCLUSIONS

Postoperative esophageal dysmotility and gastroesophageal reflux are not uncommon after GB. Preoperative testing should be done routinely. Low amplitude of contraction in the lower esophagus and increased esophageal acid exposure should be regarded as contraindications to GB. Patients with such findings should be offered an alternative procedure, such as Roux-en-Y gastric bypass.

Authors+Show Affiliations

Department of Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. michelsuter@netplus.chNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16027327

Citation

Suter, Michel, et al. "Gastric Banding Interferes With Esophageal Motility and Gastroesophageal Reflux." Archives of Surgery (Chicago, Ill. : 1960), vol. 140, no. 7, 2005, pp. 639-43.
Suter M, Dorta G, Giusti V, et al. Gastric banding interferes with esophageal motility and gastroesophageal reflux. Arch Surg. 2005;140(7):639-43.
Suter, M., Dorta, G., Giusti, V., & Calmes, J. M. (2005). Gastric banding interferes with esophageal motility and gastroesophageal reflux. Archives of Surgery (Chicago, Ill. : 1960), 140(7), pp. 639-43.
Suter M, et al. Gastric Banding Interferes With Esophageal Motility and Gastroesophageal Reflux. Arch Surg. 2005;140(7):639-43. PubMed PMID: 16027327.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gastric banding interferes with esophageal motility and gastroesophageal reflux. AU - Suter,Michel, AU - Dorta,Gian, AU - Giusti,Vittorio, AU - Calmes,Jean-Marie, PY - 2005/7/20/pubmed PY - 2005/8/12/medline PY - 2005/7/20/entrez SP - 639 EP - 43 JF - Archives of surgery (Chicago, Ill. : 1960) JO - Arch Surg VL - 140 IS - 7 N2 - BACKGROUND: Gastroesophageal reflux and progressive esophageal dilatation can develop after gastric banding (GB). HYPOTHESIS: Gastric banding may interfere with esophageal motility, enhance reflux, or promote esophageal dilatation. DESIGN: Before-after trial in patients undergoing GB. SETTING: University teaching hospital. PATIENTS AND METHODS: Between January 1999 and August 2002, 43 patients undergoing laparoscopic GB for morbid obesity underwent upper gastrointestinal endoscopy, 24-hour pH monitoring, and stationary esophageal manometry before GB and between 6 and 18 months postoperatively. MAIN OUTCOME MEASURES: Reflux symptoms, endoscopic esophagitis, pressures measured at manometry, esophageal acid exposure. RESULTS: There was no difference in the prevalence of reflux symptoms or esophagitis before and after GB. The lower esophageal sphincter was unaffected by surgery, but contractions in the lower esophagus weakened after GB, in correlation with preoperative values. There was a trend toward more postoperative nonspecific motility disorders. Esophageal acid exposure tended to decrease after GB, with fewer reflux episodes. A few patients developed massive postoperative reflux. There was no clear correlation between preoperative testing and postoperative esophageal acid exposure, although patients with abnormal preoperative acid exposure tended to maintain high values after GB. CONCLUSIONS: Postoperative esophageal dysmotility and gastroesophageal reflux are not uncommon after GB. Preoperative testing should be done routinely. Low amplitude of contraction in the lower esophagus and increased esophageal acid exposure should be regarded as contraindications to GB. Patients with such findings should be offered an alternative procedure, such as Roux-en-Y gastric bypass. SN - 0004-0010 UR - https://www.unboundmedicine.com/medline/citation/16027327/Gastric_banding_interferes_with_esophageal_motility_and_gastroesophageal_reflux_ L2 - https://jamanetwork.com/journals/jamasurgery/fullarticle/10.1001/archsurg.140.7.639 DB - PRIME DP - Unbound Medicine ER -