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


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2009-12

AUTHORS

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

ABSTRACT

BACKGROUND: The occurrence of esophageal dilation after laparoscopic adjustable silicone gastric banding (LASGB) had not been yet investigated systematically. METHODS: In this study, standardized barium swallow studies were used to assess 45 LASGB patients for the development of esophageal dilation after the operation and after a mean follow-up period of 39.3 months. The diameter of the esophagus postoperatively and during the follow-up period was calculated in millimeters using the known diameter of the gastric band. An increase in diameter exceeding 130% compared with the postoperative diameter was considered as dilation. Symptoms were assessed by a questionnaire. For 11 patients with dilation, the band was emptied and a barium swallow performed to assess whether the dilation was reversible. RESULTS: A significant increase in the esophageal diameter (median and interquartile range [IQR]) was found by comparing the early postoperative and follow-up data: median, 16.3 mm (IQR, 14-18.7 mm) versus median, 20.7 mm (IQR, 18.1-26.8 mm; p < 0.01). For 25 (55.6%) of the 45 patients, the dilation percentage exceeded 130%. For 7 of the 11 patients, the dilation after emptying of the band still exceeded 130%. The increase in esophageal diameter was significantly correlated with the duration of follow-up evaluation, regurgitation, heartburn at night, and slow esophageal clearance. CONCLUSION: 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. More... »

PAGES

2802

References to SciGraph publications

  • 1999-02. Complications Following Swedish Adjustable Gastric Banding: A Long-Term Follow-up in OBESITY SURGERY
  • 2005-06. Esophageal Dilatation after Laparoscopic Adjustable Gastric Banding: Definition and Strategy in OBESITY SURGERY
  • 2003-06. Outcome after Laparoscopic Adjustable Gastric Banding – 8 Years Experience in OBESITY SURGERY
  • 2005-10. Long-term results and gastroesophageal reflux in a series of laparoscopic adjustable gastric banding in JOURNAL OF GASTROINTESTINAL SURGERY
  • 2001-08. Pseudo-Achalasia Following Laparoscopically Placed Adjustable Gastric Banding in OBESITY SURGERY
  • 2008-06. Esophageal dilation after laparoscopic adjustable gastric banding in SURGICAL ENDOSCOPY
  • 2002-08. Adjustable Gastric and Esophagogastric Banding: A Randomized Clinical Trial in OBESITY SURGERY
  • 2002-08. Long-Term Results of Laparoscopic Adjustable Gastric Banding for the Treatment of Morbid Obesity in OBESITY SURGERY
  • 1999-08. Late Pouch Dilation after Laparoscopic Adjustable Gastric and Esophagogastric Banding: Incidence, Treatment, and Outcome in OBESITY SURGERY
  • 2005-05. Clinical and Radiological Follow-up of Laparoscopic Adjustable Gastric Bands, 1998 and 2000: A Comparison of Two Techniques in OBESITY SURGERY
  • 2001-02. The Effects of Laparoscopic Adjustable Gastric Banding on the Proximal Pouch and the Esophagus in OBESITY SURGERY
  • 2006-08. Preoperative esophageal manometry and outcome of laparoscopic adjustable silicone gastric banding in SURGICAL ENDOSCOPY
  • 2004-03. Complications after Laparoscopic Adjustable Gastric Banding for Morbid Obesity: Experience with 1,000 Patients over 7 Years in OBESITY SURGERY
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00464-009-0516-1

    DOI

    http://dx.doi.org/10.1007/s00464-009-0516-1

    DIMENSIONS

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/19466490


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    45 schema:description BACKGROUND: The occurrence of esophageal dilation after laparoscopic adjustable silicone gastric banding (LASGB) had not been yet investigated systematically. METHODS: In this study, standardized barium swallow studies were used to assess 45 LASGB patients for the development of esophageal dilation after the operation and after a mean follow-up period of 39.3 months. The diameter of the esophagus postoperatively and during the follow-up period was calculated in millimeters using the known diameter of the gastric band. An increase in diameter exceeding 130% compared with the postoperative diameter was considered as dilation. Symptoms were assessed by a questionnaire. For 11 patients with dilation, the band was emptied and a barium swallow performed to assess whether the dilation was reversible. RESULTS: A significant increase in the esophageal diameter (median and interquartile range [IQR]) was found by comparing the early postoperative and follow-up data: median, 16.3 mm (IQR, 14-18.7 mm) versus median, 20.7 mm (IQR, 18.1-26.8 mm; p < 0.01). For 25 (55.6%) of the 45 patients, the dilation percentage exceeded 130%. For 7 of the 11 patients, the dilation after emptying of the band still exceeded 130%. The increase in esophageal diameter was significantly correlated with the duration of follow-up evaluation, regurgitation, heartburn at night, and slow esophageal clearance. CONCLUSION: 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.
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