Lap Band Article Abstract (#5)

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Weiss HG, Nehoda H, Labeck B, et al.

Treatment of morbid obesity with laparoscopic adjustable gastric

banding affects esophageal motility.

Am J Surg (United States), Dec 2000, 180(6) p479-82

BACKGROUND: Laparoscopic adjustable gastric banding has become the

prefered method for the surgical treatment of morbid obesity in

Europe. It is not known whether this procedure may induce

gastroesophageal reflux and whether it may impair esophageal

peristalsis. METHODS: Laparoscopic adjustable gastric banding

(Swedish band) was performed in 43 patients (median body mass index

[bMI] 42.5 kg/m(2)). Preoperatively and 6 months postoperatively all

patients were assessed for reflux symptoms. In addition all patients

underwent preoperative and postoperative endoscopy, esophageal barium

studies and manometry, and 24-hour esophageal pH-monitoring. RESULTS:

The median BMI dropped significantly to 33.1 kg/m(2) (P <0.05).

Preoperatively 12 patients complained of reflux symptoms. Mild

esophagitis was detected in 10 patients. Postoperatively only 1

patient complained of heartburn and mild esophagitis was diagnosed in

another patient. None of the patients had dysphagia. Preoperatively a

defective LES and pathologic pH-testing were found in 9 and 15

patients, respectively. These parameters were normal in all of the

patients postoperatively. Postoperatively there was significant

impairment of LES relaxation and deterioration of esophageal

peristalsis with dilatation of the esophagus in some of the patients.

CONCLUSION: Laparoscopic adjustable gastric banding provides a

sufficient antireflux barrier and therefore prevents pathologic

gastroesophageal reflux. However, it impairs relaxation of the LES,

leading to weak esophageal peristalsis.