Reply to Letter by Klaus and Weiss (00464-008-0163-y): Re: ‘Esophageal Dilation After Laparoscopic Adjustable Gastric Banding’ (2008: 22(6)1482–1486)

Esophageal dilation after gastric banding: to test or not to test before surgery?

“…However, this systematic preoperative esophageal testing should be recommended only if it could predict these complications and assist the choice of another type of bariatric surgery less prone to induce them. On this point, we agree with the conclusions of Milone et al [3]: the data presented in the literature are insufficient to recommend esophageal manometry as a routine preoperative test. Lew et al [10] found that the outcomes after gastric banding in terms of esophageal dilation (and also in terms of weight loss and GERD symptoms) were similar whether esophageal motility disorders were present preoperatively or not.…”

“…We read with interest the article by Milone et al [1], and the ensuing controversies about the need to perform (or not) routine esophageal manometry before gastric banding [2,3]. Bariatric surgery implies a multidisciplinary evaluation of the morbidly obese patient to decide whether the indication will be helpful to the subject, in short to determine if the benefits due to surgery will outweigh the potential complications.…”