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Obesity Surgery
Published in: Obesity Surgery 8/2008

01-08-2008 | Current Opinion

Is Preoperative Manometry in Restrictive Bariatric Procedures Necessary?

Published in: Obesity Surgery | Issue 8/2008

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Abstract

Background

Restrictive bariatric procedures are frequently considered for patients with morbid obesity, because the weight loss and reduction of comorbidities are good. An impact on gastroesophageal reflux disease (GERD), which is common in this population, may be anticipated. Converse results of GERD symptoms are reported for patients after adjustable gastric banding (AGB), sleeve gastrectomy (SG), and Roux-en-Y gastric bypass (RYGBP).

Methods

A literature search was performed and, with our personal experience, are summarized.

Results

Esophageal manometry is a practical tool to identify functional disorders of the esophageal body and the lower esophageal sphincter (LES). For patients with weak esophageal body motility, AGB should not be considered as a therapeutic option because esophageal dilation, esophageal stasis, and consequent esophagitis often occur during long-term follow-up, and band deflation is inevitable. Stable body weight can therefore not be achieved in these patients. Low resting pressure of the LES may be a contraindication for SG, because taking away the angle of His further impairs the antireflux mechanism at the cardia. So far, RYGBP is an option for all morbidly obese patients regardless of the results of esophageal manometry.

Conclusion

Preoperative esophageal manometry is advised for restrictive procedures such as AGB and SG.
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Metadata
Title
Is Preoperative Manometry in Restrictive Bariatric Procedures Necessary?
Publication date
01-08-2008
Published in
Obesity Surgery / Issue 8/2008
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-007-9399-1

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