Esophageal dilation after laparoscopic adjustable gastric banding: a more systematic approach is needed

Jong, Justin R. de; Tiethof, Cas; Ramshorst, Bert van; Gooszen, Hein G.; Smout, A. J. P. M.

doi:10.1007/s00464-009-0516-1

Cited by 16 publications

(16 citation statements)

References 22 publications

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“…Esophageal motility showed an increased number of defective propagations, LES relaxation was disturbed and resting pressure decreased. These synergistic factors promote esophageal and pouch dilation,7 19 and larger overall esophageal diameter,20 potentially leading to an epiphrenic diverticulum as a late complication with its own aspiration risk 21 22. Such a reservoir was not found in our patient, while achalasia and protracted pouch emptying were.…”

Section: Discussionmentioning

confidence: 66%

Airway management concerns in patient with gastric banding procedures

et al. 2013

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Laparoscopic adjustable gastric band (LAGB) is considered a relatively safe and effective treatment for obesity. Even after weight loss patients with LAGB are at increased risk of pulmonary aspiration during induction of general anaesthesia, possibly due to LAGB-induced anatomical and functional changes. We present a case of aspiration in a patient with LAGB following significant weight loss and 14 h of preoperative fasting and review the literature. In the presence of LAGB we propose specific anaesthesia management at least consisting of anti-Trendelenburg positioning; avoidance of mask-ventilation; use of the local rapid sequence induction strategy with endotracheal intubation and fully awake extubation.

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Section: Discussionmentioning

confidence: 66%

Airway management concerns in patient with gastric banding procedures

et al. 2013

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“…However, the man-made obstruction near the esophageal-gastric junction may lead to esophageal dilation and motility dysfunction [19-21]. The long-term impacts of gastric banding are not well known because of a relatively short history of this procedure.…”

Section: Discussionmentioning

confidence: 99%

“…18 However, recent data showed that gastric banding leads to marked esophageal dilation and motility dysfunction with weakened contractions in the esophageal body. [19][20][21] The mechanism for the motility dysfunction in gastric banding patients is not clear.…”

Section: Introductionmentioning

confidence: 99%

“…This surgery leads to marked short-term weight loss, largely due to early postprandial satiation and decreased food-intake due to the man-made obstruction near the esophageal-gastric junction [18]. However, recent data showed that gastric banding leads to marked esophageal dilation and motility dysfunction with weakened contractions in the esophageal body [19-21]. The mechanism for the motility dysfunction in gastric banding patients is not clear.…”

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confidence: 99%

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Mechano‐transcription of COX‐2 is a common response to lumen dilation of the rat gastrointestinal tract

Lin

Shi

2012

Neurogastroenterology Motil

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Background In obstructive bowel disorders (OBDs) such as achalasia, pyloric stenosis, and bowel obstruction, the lumen of the affected segments is markedly dilated and the motility function is significantly impaired. We tested the hypothesis that mechanical stress in lumen dilation leads to induction of cyclooxygenase‐2 (COX‐2) in smooth muscle throughout the gastrointestinal (GI) tract, contributing to motility dysfunction. Methods Lumen dilation was induced in vivo with obstruction bands (12 × 3 mm) applied over the lower esophageal sphincter (LES), the pyloric sphincter, and the ileum in rats for 48 h. Mechanical stretch in vivo was also emulated by balloon distension of the distal colon. Direct stretch of muscle strips from the esophagus, gastric fundus, and ileum was mimicked in an in vitro tissue culture system. Key Results Partial obstruction in the LES, pylorus, and ileum significantly increased the expression of COX‐2 mRNA and protein in the muscularis externae of the dilated segment oral to the occlusions, but not in the aboral segment. Direct stretch of the lumen in vivo or of muscle strips in vitro markedly induced COX‐2 expression. The smooth muscle contractility was significantly suppressed in the balloon‐distended segments. However, treatment with COX‐2 inhibitor NS‐398 restored the contractility. Furthermore, in vivo administration of NS‐398 in gastric outlet obstruction significantly improved gastric emptying. Conclusions & Inferences Mechanical dilation of the gut lumen by occlusion or direct distension induces gene expression of COX‐2 throughout the GI tract. Mechanical stress‐induced COX‐2 contributes to motility dysfunction in conditions with lumen dilation.

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“…However, safety and efficiency of LAGB in long term (R5 years) is inconsistent. 6,11,12 The main complications of LAGB include band erosion, slippage, port infection, pouch and esophageal dilatation, and weight loss failure that usually end up in band removal. 13,14 In Iran, LAGB is also a common bariatric surgery that can result in various and some different outcomes.…”

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confidence: 99%

Laparoscopic adjustable gastric banding: efficacy and consequences over a 13-year period

Toolabi

Farid

2016

The American Journal of Surgery

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Esophageal dilation after laparoscopic adjustable gastric banding: a more systematic approach is needed

Abstract: Laparoscopic adjustable gastric banding causes esophageal dilation in about half of patients. This dilation is correlated with symptoms and is partly reversible after emptying of the band. The clinical relevance of the dilation is unclear.

Cited by 16 publications

References 22 publications

Airway management concerns in patient with gastric banding procedures

Airway management concerns in patient with gastric banding procedures

Mechano‐transcription of COX‐2 is a common response to lumen dilation of the rat gastrointestinal tract

Laparoscopic adjustable gastric banding: efficacy and consequences over a 13-year period

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