Prevalent Esophageal Body Motility Disorders Underlie Aggravation of GERD Symptoms in Morbidly Obese Patients Following Adjustable Gastric Banding

Abstract

Preexisting gastroesophageal reflux disease (GERD) and esophageal motility disorders may affect the outcome of laparoscopic adjustable gastric banding (AGB).

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

“…Esophageal dilation found in barium studies reported in literature show an incidence ranging from 0.5% to 77.9% [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] (Table 4). A few reports mention esophageal dilation as one of the reasons for reoperating after LASGB (1.8-4.1% of the reoperations) [10,13,14].…”

“…Klaus et al [17] reported that dilation was related to poor esophageal motility. However reports about the long-term effects of esophageal dilation on esophageal motility are lacking, and the role of altered motility in the development of esophageal dilation also is unclear.…”

“…Assessment of esophageal dilation after emptying of the band was reported in four studies [1,4,17,21]. In all these studies, a decrease in the dilation was observed, but details were not provided.…”

Anesthetic Management in Body Countouring Surgery

“…That may be related to the complex physiological modifications induced by bariatric surgery. Several studies have suggested that esophageal-gastric peristalsis is altered after gastric banding [5][6][7]. Moreover, lower esophageal sphincter relaxation impairment is also reported [6,8].…”

Esophageal dilation after laparoscopic adjustable gastric banding Milone et al. Surg Endosc 2008;22:1482–1486

“…If the preoperative esophageal manometry shows a weak esophageal body motility, the patient is condemned to have esophageal stasis at the mid follow-up period, resulting in GERD-like symptoms with esophageal dilation [2,3]. This problem more often occurs if a technique without gastric pouch formation is used [4,5].…”