Advertisement

Surgical Endoscopy

, Volume 22, Issue 6, pp 1482–1486 | Cite as

Esophageal dilation after laparoscopic adjustable gastric banding

  • L. Milone
  • A. Daud
  • E. Durak
  • L. Olivero-Rivera
  • B. Schrope
  • W. B. Inabnet
  • D. Davis
  • M. Bessler
Article

Abstract

Background

Esophageal dilation can occur after laparoscopic adjustable gastric banding (LAGB). There are few studies in the literature that describe the outcomes of patients with esophageal dilation. The aim of this article is to evaluate weight loss and symptomatic outcome in patients with esophageal dilation after LAGB.

Methods

We performed a retrospective chart review of all LAGBs performed at Columbia University Medical Center from March 2001 to December 2006. Patients with barium swallow (BaSw) at 1 year after surgery were evaluated for esophageal diameter. A diameter of 35 mm or greater was considered to be dilated. Data collected before surgery and at 6 months and 1, 2 and 3 years after surgery were weight, body mass index (BMI), status of co-morbidities, eating parameters, and esophageal dilation as evaluated by BaSw.

Results

Of 440 patients, 121 had follow-up with a clinic visit and BaSw performed at 1 year. Seventeen patients (10 women and 7 men) (14%) were found to have esophageal dilation with an average diameter of 40.9 ± 4.6 mm. There were no significant differences in percent of excess weight lost at any time point; however, GERD symptoms and emesis were more frequent in patients with dilated esophagus than in those without dilation. Intolerance of bread, rice, meat, and pasta was not different at any time during the study.

Conclusions

In our experience the incidence of esophageal dilation at 1 year after LAGB was 14%. The presence of dilation did not affect percent excess weight loss (%EWL). GERD symptoms and emesis are more frequent in patients who develop esophageal dilation.

Keywords

Morbid obesity Obesity surgery Laparoscopic adjustable gastric banding Esophageal dilation 

References

  1. 1.
    Bueter M, Thalheimer A, Meyer D, Fein M. (2006) Band erosion and passage, causing small bowel obstruction. Obes Surg 16:1679–1682PubMedCrossRefGoogle Scholar
  2. 2.
    Dargent J (2005) Esophageal dilatation after laparoscopic adjustable gastric banding: definition and strategy. Obes Surg 15:843–48PubMedCrossRefGoogle Scholar
  3. 3.
    DeMaria EJ, Jamal MK (2005) Laparoscopic adjustable gastric banding: evolving clinical experience. Surg Clin North Am 85:773–87PubMedCrossRefGoogle Scholar
  4. 4.
    DeMaria EJ, Sugerman HJ, Meador JG, Doty JM, Kellum J, Wolfe L, Szucs RA, Turner MA (2001) High failure rate after Laparoscopic Adjustable silicone gastric banding for treatment of morbid obesity. Ann Surg 233;908–818CrossRefGoogle Scholar
  5. 5.
    Fan FC, Hong D, Pereira N, Patterson EF (2005) Laparoscopic adjustable gastric banding versus laparoscopic gastric bypass for morbid obesity: A single-institution comparison study of early results. J Gastrointest Surg 9:30–41CrossRefGoogle Scholar
  6. 6.
    Lew JI, Daud A, DiGorgi L, Olivero-Rivera L, Davis DG, Bessler M (2006) Preoperative esophageal manometry and outcome of laparoscopic adjustable silicone gastric banding. Surg Endosc 20:1242–1247PubMedCrossRefGoogle Scholar
  7. 7.
    Rao AD, Ramalingam G. (2006) Abstract exsanguinating hemorrhage following gastric erosion after laparoscopic adjustable gastric banding. Obes Surg 16:1675–1678PubMedCrossRefGoogle Scholar
  8. 8.
    Sarker S, Herold K, Creech S, Shayani V (2004) Early and late complications following laparoscopic adjustable gastric banding. The Am Surg 70:146–150Google Scholar
  9. 9.
    Wiesner W, Hauser M, Schob O, Weber M, Hauser RS (2001) Pseudo-achalasia following laparoscopically placed adjustable gastric banding. Obes Surg 11:513–18PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • L. Milone
    • 1
  • A. Daud
    • 1
  • E. Durak
    • 1
  • L. Olivero-Rivera
    • 1
  • B. Schrope
    • 1
  • W. B. Inabnet
    • 1
  • D. Davis
    • 1
  • M. Bessler
    • 1
  1. 1.Department of Surgery, Minimal Access Surgery CenterColumbia University College of Physician and SurgeonsNew YorkUSA

Personalised recommendations