Esophageal dilation after laparoscopic adjustable gastric banding.
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.
Milone
L
L
Department of Surgery, Minimal Access Surgery Center, Columbia University College of Physician and Surgeons, 630 West 168 Street, New York, New York 10032, USA.
Daud
A
A
Durak
E
E
Olivero-Rivera
L
L
Schrope
B
B
Inabnet
W B
WB
Davis
D
D
Bessler
M
M
D000284:Administration, Oral; D000328:Adult; D001466:Barium Sulfate / Q000008:administration & dosage; D003287:Contrast Media / Q000008:administration & dosage; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging / Q000209:etiology; D004947:Esophagus / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology* / Q000473:pathology; D013902:Radiography, Thoracic / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors
D003287:Contrast Media; D001466:Barium Sulfate