Article
Esophageal dysmotility after laparoscopic gastric band surgery
Obesity Surgery
(2013)
Abstract
Background:
The effect of the laparoscopic adjustable gastric
band (LAGB) on the esophagus has been the subject of few
studies despite recognition of its clinical importance. The aim
of this study was to investigate the frequency and clinical
effect of esophageal dysmotility and dilatation after LAGB.
Methods:
We undertook a retrospective analysis of 50 consec-
utive patients with no dysmotility on perioperative video
contrast swallow who underwent primary LAGB operation.
All patients had serial focused postoperative contrast studies
for band adjustments at least 6 months post-LAGB. Clinical
and radiological outcomes were assessed.
Results:
Median follow-up time was 18 months (range 7
–
39 months), and the median number of contrast swallows
per patient was 5. The mean excess weight loss (EWL) overall
was 47 % (standard deviation (SD) 22.3). Radiological abnor-
malities were recorded in 17 patients (34 %, 95 % confidence
interval (CI) 21
–
49 %), of whom 15 had radiological
dysmotility and 7 had esophageal dilatation (five patients
had both dysmotility and dilatation). Of these 17 patients,
six (35 %) developed significant symptoms of dysphagia,
gastroesophageal reflux disease (GERD) or regurgitation re-
quiring fluid removal. In comparison, 12 of 33 (36 %) patients
without radiological abnormalities developed symptoms re-
quiring fluid removal (
p
=1.00). Patients with radiological
abnormalities were significantly older than those without the-
se abnormalities. Symptoms were alleviated by removing
fluid in most patients.
Conclusions:
The LAGB operation results in the development
of radiological esophageal dysmotility in a significant propor-
tion of patients. It is not clear if these changes are associated
with an increased risk of significant symptoms. Fluid removal
can reverse these abnormalities and their associated
symptoms.
Disciplines
Publication Date
2013
DOI
10.1007/s11695-013-1134-5
Citation Information
Le Page, P., Kwon, S., Lord, S., and Lord, R. (2013). Esophageal dysmotility after laparoscopic gastric band surgery. Obesity Surgery, 24(4), 625-630. DOI: 10.1007/s11695-013-1134-5