Does gastric banding for morbid obesity reduce or increase gastroesophageal reflux?

• Published in: Obesity surgery 2006-11, Vol.16 (11), p.1469-1474
• Main Authors: Tolonen, Pekka, Victorzon, Mikael, Niemi, Risto, Mäkelä, Jyrki
• Format: Article
• Language: English
• Subjects: Adult; Esophageal pH Monitoring; Female; Follow-Up Studies; Gastroesophageal Reflux - complications; Gastroesophageal Reflux - pathology; Gastroesophageal Reflux - prevention & control; Gastrointestinal diseases; Gastroplasty; Humans; Laparoscopy; Male; Manometry; Middle Aged; Obesity, Morbid - complications; Obesity, Morbid - surgery; Prospective Studies; Throat; Treatment Outcome
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1381/096089206778870120

Conflicting results regarding the influence of laparoscopic adjustable gastric banding (LAGB) on gastroesophageal reflux disease (GERD) have been published. A prospective follow-up study was conducted in 31 patients (male/female 5/26, mean age 44 +/- 11 SD years) with 24-hour pH and manometry recordings, symptom assessment, and upper GI endoscopy. Total number of reflux episodes decreased from a mean value of 44.6 +/- 23.7 SD preoperatively to 22.9 +/- 17.1 postoperatively (P=0.0006), after a median follow-up time of 19 months (range 7-32 months). Total reflux time decreased from 9.5% +/- 6.2% to 3.5% +/- 3.7%, P=0.0009, and DeMeester score decreased from 38.5 +/- 24.9 to 18.6 +/- 20.4, P=0.03. Symptomatic patients decreased from 48.4% preoperatively to 16.1% postoperatively (P=0.01), medication for GERD decreased from 35.5% to 12.9% (P=0.05), and the diagnosis of GERD on 24-hour pH recordings decreased from 77.4% to 37.5% (P=0.01). There were no pouch enlargements seen on upper GI endoscopy. Esophageal motility was unchanged, but 36% of the patients had incomplete relaxation of the lower esophageal sphincter following the operation (P