Esophageal dysmotility disorders after laparoscopic gastric banding - An underestimated complication

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dc.contributor.authorNaef, M.
dc.contributor.authorMouton, W.
dc.contributor.authorNaef, U.
dc.contributor.authorvan der Weg, B.
dc.contributor.authorMaddern, G.
dc.contributor.authorWagner, H.
dc.date.issued2011
dc.description.abstract<h4>Objective</h4>To evaluate the effects of laparoscopic adjustable gastric banding (LAGB) on esophageal dysfunction over the long term in a prospective study, based on a 12-year experience.<h4>Background</h4>Esophageal motility disorders and dilatation after LAGB have been reported. However, only a few studies present long-term follow-up data.<h4>Methods</h4>Between June 1998 and June 2009, all patients with implantation of a LAGB were enrolled in a prospective clinical trial including a yearly barium swallow. Esophageal motility disorders were recorded and classified over the period. An esophageal diameter of 35 mm or greater was considered dilated.<h4>Results</h4>Laparoscopic adjustable gastric banding was performed in 167 patients (120 females and 47 males) with a mean age of 40.1±5.2 years. Overall patient follow-up was 94%. Esophageal dysmotility disorders were found in 108 patients (68.8% of patients followed). Esophageal dilatation occurred in 40 patients (25.5%)with a mean esophageal diameter of 47.3±6.9 mm(35.0–94.6) after a follow-up of 73.8 ± 6.8 months (36–120) compared with 26.2± 2.8 mm (18.3–34.2) in patients without dilatation (diameter of <35 mm)(P < 0.01). Thirty-four patients suffered from stage III dilatation (band deflation necessary) and 6 from stage IV (major achalasia-like dilatation, band removal mandatory). In 29 patients, upper endoscopy was carried out because of heartburn/dysphagia. In 18 patients, the endoscopy was normal; 9 patients suffered from gastroesophageal reflux disease, 1 from a stenosis, and 1 from a hiatus hernia.<h4>Conclusions</h4>This study demonstrates that esophageal motility disorders after LAGB are frequent, poorly appreciated complications. Despite adequate excess weight loss, LAGB should probably not be considered the procedure of first choice and should be performed only in selected cases until reliable criteria for patients with a low risk for the procedure's long-term complications are developed.
dc.description.statementofresponsibilityMarkus Naef, Wolfgang G. Mouton, Ursula Naef, Boudewijn van der Weg, Guy J. Maddern and Hans E. Wagner
dc.identifier.citationAnnals of Surgery, 2011; 253(2):285-290
dc.identifier.doi10.1097/SLA.0b013e318206843e
dc.identifier.issn0003-4932
dc.identifier.issn1528-1140
dc.identifier.orcidMaddern, G. [0000-0003-2064-181X]
dc.identifier.urihttp://hdl.handle.net/2440/66901
dc.language.isoen
dc.publisherLippincott Williams & Wilkins
dc.rights© 2011 Lippincott Williams & Wilkins, Inc.
dc.source.urihttps://doi.org/10.1097/sla.0b013e318206843e
dc.subjectEsophagus
dc.subjectHumans
dc.subjectEsophageal Motility Disorders
dc.subjectGastroesophageal Reflux
dc.subjectObesity, Morbid
dc.subjectRadiography
dc.subjectLaparoscopy
dc.subjectGastroplasty
dc.subjectRisk Factors
dc.subjectAdult
dc.subjectAged
dc.subjectMiddle Aged
dc.subjectFemale
dc.subjectMale
dc.subjectYoung Adult
dc.titleEsophageal dysmotility disorders after laparoscopic gastric banding - An underestimated complication
dc.typeJournal article
pubs.publication-statusPublished

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