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Laparoscopic Adjustable Gastric Banding Outcomes in Patients with Gastroesophageal Reflux Disease or Hiatal Hernia

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Abstract

Background

Gastroesophageal reflux disease (GERD) and hiatal hernia (HH) are classically considered contraindications to bariatric restrictive procedures. Despite the high number of studies that have been published, the relationship between laparoscopic adjustable gastric banding (LAGB) and GERD/HH is still not clear.

Methods

We have retrospectively analyzed the outcomes of LAGB in patients operated in 2010 with HH and/or GERD. The gastroesophageal reflux was diagnosed if the patients had heartburn and regurgitation more than once a week, and hiatal hernia was assessed by esophagogastroduodenoscopy and/or upper GI radiogram with swallow. Data on heartburn, assumption of antacid medication, weight loss, and rate of complications in both patients with and without GERD or HH were collected.

Results

One hundred and twenty patients that underwent LAGB at our department were enrolled in our study; 40 had symptoms of GERD and 25 had hiatal hernia preoperatively. There was no difference of percentage excess weight loss (%EWL) at 12 months (45.4 ± 20.4 vs 4.6 ± 19.5 kg/m2) and 36 months follow-up (49.4 ± 16.5 vs 48.6 ± 18.9 kg/m2) between asymptomatic patients and patients with HH or GERD symptoms. The number of patients with preoperative heartburn (40 to 10) and/or assumption of antacid drugs (38 to 7) significantly decreased after LAGB

Conclusions

LAGB is an effective and safe surgical treatment for morbidly obesity in patients with GERD or HH, since it induces both a significant weight loss and an improvement of reflux symptoms.

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References

  1. Wilson LJ, Ma W, Hirschowitz BI. Association of obesity with hiatal hernia and esophagitis. Am J Gastroenterol. 1999;94(10):2840–4.

    Article  CAS  PubMed  Google Scholar 

  2. O'Brien PE, MacDonald L, Anderson M, et al. Long-term outcomes after bariatric surgery: fifteen-year follow-up of adjustable gastric banding and a systematic review of the bariatric surgical literature. Ann Surg. 2013;257(1):87–94.

    Article  PubMed  Google Scholar 

  3. Morino M, Toppino M, Garrone C. Disappointing long-term results of laparoscopic adjustable silicone gastric banding. Br J Surg. 1997;84(6):868–9.

    Article  CAS  PubMed  Google Scholar 

  4. Westling A, Bjurling K, Ohrvall M, et al. Silicone-adjustable gastric banding: disappointing results. Obes Surg. 1998;8(4):467–74.

    Article  CAS  PubMed  Google Scholar 

  5. Forsell P, Hallerback B, Glise H, et al. Complications following Swedish adjustable gastric banding: a long-term follow-up. Obes Surg. 1999;9:11–6.

    Article  CAS  PubMed  Google Scholar 

  6. Greenstein RJ, Nissan A, Jaffin B. Esophageal anatomy and function in laparoscopic gastric restrictive bariatric surgery: implications for patient selection. Obes Surg. 1998;8:199–206.

    Article  CAS  PubMed  Google Scholar 

  7. Katz PO, Gerson LB, Vela MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2013;108:308–28. doi:10.1038/ajg.2012.444.

    Article  PubMed  Google Scholar 

  8. Canon CL, Morgan DE, Einstein DM, et al. Surgical approach to gastroesophageal reflux disease: what the radiologist needs to know. Radiographics. 2005;25(6):1485–99.

    Article  PubMed  Google Scholar 

  9. Angrisani L, Di Lorenzo N, Favretti F, et al. Italian Collaborative Study Group for LAP-BAND. The Italian Group for LAP-BAND: predictive value of initial body mass index for weight loss after 5 years of follow-up. Surg Endosc. 2004;18(10):1524–7.

    Article  CAS  PubMed  Google Scholar 

  10. Angrisani L, Favretti F, Furbetta F, et al. Italian Group for lap-band system: results of multicenter study on patients with BMI < or =35 kg/m2. Obes Surg. 2004;14(3):415–8.

    Article  CAS  PubMed  Google Scholar 

  11. Pilone V, Mozzi E, Schettino AM, et al. Improvement in health-related quality of life in first year after laparoscopic adjustable gastric banding. Surg Obes Relat Dis. 2012;8(3):260–8.

    Article  PubMed  Google Scholar 

  12. Busetto L, Pilone V, Schettino AM, et al. Determinants of health-related quality of life in morbid obese candidates to gastric banding. Eat Weight Disord. 2012;17(2):e93–100.

    CAS  PubMed  Google Scholar 

  13. Khan A, Ren-Fielding C, Traube M. Potentially reversible pseudoachalasia after laparoscopic adjustable gastric banding. J Clin Gastroenterol. 2011;45(9):775–9.

    Article  PubMed  Google Scholar 

  14. Burton PR, Brown WA. The mechanism of weight loss with laparoscopic adjustable gastric banding: induction of satiety not restriction. Int J Obes (Lond). 2011;35 Suppl 3:S26–30.

    Article  Google Scholar 

  15. Burton PR, Brown WA, Laurie C, et al. Mechanisms of bolus clearance in patients with laparoscopic adjustable gastric bands. Obes Surg. 2010;20(9):1265–72.

    Article  PubMed  Google Scholar 

  16. Burton PR, Brown W, Laurie C, et al. Outcomes, satiety, and adverse upper gastrointestinal symptoms following laparoscopic adjustable gastric banding. Obes Surg. 2011;21:574–81.

    Article  PubMed  Google Scholar 

  17. Robert M, Golse N, Espalieu P, et al. Achalasia-Like Disorder After Laparoscopic Adjustable Gastric Banding: a Reversible Side Effect? Obes Surg. 2012;22:704–11.

    Article  CAS  PubMed  Google Scholar 

  18. O'Rourke RW, Seltman AK, Chang EY, et al. A model for gastric banding in the treatment of morbid obesity: the effect of chronic partial gastric outlet obstruction on esophageal physiology. Ann Surg. 2006;244(5):723–33.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Azagury DE, Varban O, Tavakkolizadeh A, et al. Does laparoscopic gastric banding create hiatal hernias? Surg Obes Relat Dis. 2013;9(1):48–52.

    Article  PubMed  Google Scholar 

  20. Angrisani L, Iovino P, Lorenzo M, et al. Treatment of morbid obesity and gastroesophageal reflux with hiatal hernia by lap-band. Obes Surg. 1999;9:396–8.

    Article  CAS  PubMed  Google Scholar 

  21. Dixon JB, O’Brien PE. Gastroesophageal reflux in obesity: the effect of lap-band placement. Obes Surg. 1999;9:527–31.

    Article  CAS  PubMed  Google Scholar 

  22. Iovino P, Angrisani L, Tremolaterra F, et al. Abnormal esophageal acid exposure is common in morbidly obese patients and improves after successful Lap-band system implantation. Surg Endosc. 2001;16:1631–5.

    Article  Google Scholar 

  23. Pilone V, Di Micco R, Monda A, et al. Positive findings in preoperative testing prior to gastric banding: their real value. Minerva Chir. 2013;68(6):529–35.

    CAS  PubMed  Google Scholar 

  24. Macran S, Wileman S, Barton G, et al. The development of a new measure of quality of life in the management of gastro-oesophageal reflux disease: the Reflux questionnaire. Qual Life Res. 2007;16:331–43.

    Article  PubMed  Google Scholar 

  25. Jones R, Junghard O, Dent J, et al. Development of the GerdQ, a tool for the diagnosis and management of gastro-oesophageal reflux disease in primary care. Aliment Pharmacol Ther. 2009;30(10):1030–8.

    Article  CAS  PubMed  Google Scholar 

  26. Vakil N, van Zanten SV, Kahrilas P, et al. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol. 2006;101(8):1900–20.

    Article  PubMed  Google Scholar 

  27. Che F, Nguyen B, Cohen A, et al. Prevalence of hiatal hernia in the morbidly obese. Surg Obes Relat Dis. 2013;9(6):920–4.

    Article  PubMed  Google Scholar 

  28. Suter M, Dorta G, Giusti V, et al. Gastro-esophageal reflux and esophageal motility disorders in morbidly obese patients. Obes Surg. 2004;14(7):959–66.

    Article  CAS  PubMed  Google Scholar 

  29. Dolan K, Finch R, Fielding G. Laparoscopic gastric banding and crural repair in the obese patient with a hiatal hernia. Obes Surg. 2003;13(5):772–5.

    Article  PubMed  Google Scholar 

  30. Gulkarov I, Wetterau M, Ren CJ, et al. Hiatal hernia repair at the initial laparoscopic adjustable gastric band operation reduces the need for reoperation. Surg Endosc. 2008;22(4):1035–41.

    Article  PubMed  Google Scholar 

  31. Frezza EE, Barton A. Wachtel MS Crural repair permits morbidly obese patients with not large hiatal hernia to choose laparoscopic adjustable banding as a bariatric surgical treatment. Obes Surg. 2008;18(5):583–8.

    Article  PubMed  Google Scholar 

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Conflict of interest

All authors declare no conflict of interest in writing this article.

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Authors and Affiliations

  1. Department of Medicine and Surgery, University of Salerno, Salerno, Italy

    Vincenzo Pilone

  2. Department of Gastroenterology Endocrinology and Surgery, University of Naples, Naples, Italy

    Antonio Vitiello, Ariola Hasani, Rosa Di Micco, Angela Monda, Giuliano Izzo & Pietro Forestieri

Authors
  1. Vincenzo Pilone
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  2. Antonio Vitiello
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  3. Ariola Hasani
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  4. Rosa Di Micco
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  5. Angela Monda
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  6. Giuliano Izzo
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  7. Pietro Forestieri
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Correspondence to Antonio Vitiello.

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Pilone, V., Vitiello, A., Hasani, A. et al. Laparoscopic Adjustable Gastric Banding Outcomes in Patients with Gastroesophageal Reflux Disease or Hiatal Hernia. OBES SURG 25, 290–294 (2015). https://doi.org/10.1007/s11695-014-1366-z

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