The role of endoscopy after vertical banded gastroplasty.
Since 1984, a total of 99 patients underwent vertical banded gastroplasty (VBG) through protocol (pouch 8 ml in size, band 4.3 cm in circumference) to treat morbid obesity. Follow-up was obtained in 95 patients. Thirty upper gastrointestinal endoscopies were performed post-operatively in 17 patients. Indications were nausea/vomiting in 11, epigastric pain in 4, acute obstructive symptoms in 4, and miscellaneous in three. Findings included food impaction in 10, distal esophagitis in 8, gastritis in 4, and a normal examination in 2. Only 4 of 10 food impactions were associated with an excessively narrowed gastroplasty outlet. Eight patients had an excessively narrowed gastric stoma: two became asymptomatic with dietary modification only and six underwent dilation therapy (dilator range from 8 to 18 mm in diameter) with immediate resolution of symptoms in four of six. One of the two patients unresponsive to dilation was lost to follow-up, and the other required surgical revision after multiple dilation sessions.
Wayman
C S
CS
Department of Internal Medicine, University of South Florida College of Medicine, Tampa.
Nord
J H
JH
Combs
W M
WM
Rosemurgy
A S
AS
D004106:Dilatation; D016145:Endoscopy, Digestive System / Q000295:instrumentation / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D013997:Time Factors