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Surgical Endoscopy
Published in: Surgical Endoscopy 8/2006

01-08-2006

Preoperative esophageal manometry and outcome of laparoscopic adjustable silicone gastric banding

Authors: J. I. Lew, A. Daud, M. F. DiGorgi, L. Olivero-Rivera, D. G. Davis, M. Bessler

Published in: Surgical Endoscopy | Issue 8/2006

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Abstract

Background

Laparoscopic adjustable silicone gastric banding (LASGB) for morbid obesity has been reported to provide long-term weight loss with a low risk of operative complications. Nevertheless, esophageal dilation leading to achalasia-like and reflux symptoms is a feared complication of LASGB. This study evaluates the clinical benefit of routine preoperative esophageal manometry in predicting outcome after LASGB in morbidly obese patients.

Method

A review of prospectively collected data on 77 patients who underwent routine esophageal manometry prior to LASGB for morbid obesity from February 2001 to September 2003 was performed. Aberrant motility, abnormal lower esophageal sphincter (LES) pressures, and other nonspecific esophageal motility disorders noted on preoperative esophageal manometry defined patients of the abnormal manometry group. Outcome differences in weight loss, emesis, band complications, and gastroesophageal reflux disease (GERD) resolution or improvement were compared between patients of the abnormal and normal manometry groups after LASGB. Analysis of variance (ANOVA) and chi-square tests were performed to determine the significance of these outcomes.

Results

Of the patients tested, 14 had abnormal esophageal manometry results, whereas 63 had normal manometry results before LASGB. There was no significant difference in percent excess weight loss (%EWL) at 6 and 12 months between the groups after gastric banding. Severe postoperative emesis occurred more frequently in patients with abnormal manometry results than in those with normal manometry results. There were two band-related complications, both of which occurred in patients of the normal manometry group.

Conclusions

Preoperative esophageal manometry does not predict weight loss or GERD outcomes after LASGB in morbidly obese patients. Postoperative emesis was more common in patients with abnormal manometry findings, but such symptoms were manageable and did not lead to poor weight loss or to band removal or increased band-related complications.
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Metadata
Title
Preoperative esophageal manometry and outcome of laparoscopic adjustable silicone gastric banding
Authors
J. I. Lew
A. Daud
M. F. DiGorgi
L. Olivero-Rivera
D. G. Davis
M. Bessler
Publication date
01-08-2006
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 8/2006
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-005-0589-4

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