Reflux and the band...

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1: Obes Surg. 2004 Mar;14(3):399-406. Related Articles, Links

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The influence of laparoscopic adjustable gastric banding on gastroesophageal reflux.

de Jong JR, van Ramshorst B, Timmer R, Gooszen HG, Smout AJ.

Department of Surgery, University Medical Center, Heidelberglaan 100, CX-3584 Utrecht, The Netherlands. jr.dejong@hccnet.nl

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.

CONCLUSION: LAGB decreases gastroesophageal reflux if there is no pouch formation during follow-up.

PMID: 15072663 [PubMed]