The influence of laparoscopic adjustable gastric banding on gastroesophageal reflux.
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.
de Jong
Justin R
JR
Department of Surgery, University Medical Center, Heidelberglaan 100, CX-3584 Utrecht, The Netherlands. jr.dejong@hccnet.nl
van Ramshorst
Bert
B
Timmer
Robin
R
Gooszen
Hein G
HG
Smout
André J P M
AJ
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