Esophageal Dysmotility After Laparoscopic Gastric Band Surgery
| Autor: | Philip A Le Page, Sebastianus Kwon, Sarah J. Lord, Reginald V. Lord |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Gastroplasty Endocrinology Diabetes and Metabolism Contrast Media Esophageal Diseases Gastroenterology Morbid obesity Postoperative Complications Internal medicine Weight Loss medicine Humans Esophageal Motility Disorders Adjustable gastric band Esophagus Retrospective Studies Nutrition and Dietetics business.industry Middle Aged Esophageal dysmotility digestive system diseases Obesity Morbid Surgery Gastric band medicine.anatomical_structure Gastroesophageal Reflux Female Laparoscopy business Dilatation Pathologic |
| Zdroj: | Obesity Surgery. 24:625-630 |
| ISSN: | 1708-0428 0960-8923 |
| DOI: | 10.1007/s11695-013-1134-5 |
| Popis: | 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.We undertook a retrospective analysis of 50 consecutive 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.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 abnormalities 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 requiring fluid removal. In comparison, 12 of 33 (36 %) patients without radiological abnormalities developed symptoms requiring fluid removal (p = 1.00). Patients with radiological abnormalities were significantly older than those without these abnormalities. Symptoms were alleviated by removing fluid in most patients.The LAGB operation results in the development of radiological esophageal dysmotility in a significant proportion 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. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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