title: The influence of laparoscopic adjustable gastric banding on gastroesophageal reflux.
abstract: BACKGROUND
  Laparoscopic adjustable gastric banding (LAGB) influences gastroesophageal reflux.
  
  
  METHODS
  26 patients undergoing gastric banding were assessed by a questionnaire for symptom analysis, 24-hour pH monitoring, endoscopy and barium swallows, preoperatively, at 6 weeks and at 6 months after operation.
  
  
  RESULTS
  Gastric banding had minimal effect on heartburn scores, but regurgitation and belching scores increased significantly during follow-up. Use of acid-reducing drugs decreased significantly at 6 weeks and increased significantly at 6 months. Pathological reflux was present in 13 of the 26 patients preoperatively. At 6 months pathological reflux was found in only 6 of these 13 patients, but 4 of the 13 patients with preoperative normal reflux patterns had developed pathological reflux. 6 months after the operation esophagitis had disappeared in 6 patients and was increased in 9 patients. In 9 patients, a pouch was found at 6 months. Pouch formation was significantly correlated with the presence of pathological reflux, esophagitis and the use of acid-reducing medication. Preoperative presence of a hiatal hernia did not influence pouch formation or pathological reflux.
  
  
  CONCLUSIONS
  LAGB decreases gastroesophageal reflux if there is no pouch formation during follow-up.
authors.affiliation: Department of Surgery, University Medical Center, Heidelberglaan 100, CX-3584 Utrecht, The Netherlands. jr.dejong@hccnet.nl
authors.forename: Justin R
authors.initials: JR
authors.lastname: de Jong
authors.forename: Bert
authors.initials: B
authors.lastname: van Ramshorst
authors.forename: Robin
authors.initials: R
authors.lastname: Timmer
authors.forename: Hein G
authors.initials: HG
authors.lastname: Gooszen
authors.forename: André J P M
authors.initials: AJ
authors.lastname: Smout
mesh_terms: D000328:Adult; D016145:Endoscopy, Digestive System; D004943:Esophagogastric Junction / Q000503:physiopathology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D015391:Gastroplasty / Q000009:adverse effects*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011446:Prospective Studies