Effect of morbid obesity, gastric banding and gastric bypass on esophageal symptoms, mucosa and function.

Borovicka, Jan; Krieger-Grübel, Claudia; van der Weg, Boudewijn; Thurnheer, Martin; Schultes, Bernd; Sulz, Michael Christian; Gutzwiler, Jean-Pierre; Bisang, Philipp; Pohl, Daniel; Fried, Michael; Meyenberger, Christa; Tutuian, Radu (2017). Effect of morbid obesity, gastric banding and gastric bypass on esophageal symptoms, mucosa and function. Surgical endoscopy and other interventional techniques, 31(2), pp. 552-560. Springer 10.1007/s00464-016-4996-5

Preview

Text Effect of morbid obesity, gastric banding and gastric bypass.pdf - Published Version Available under License Publisher holds Copyright. Download (847kB) | Preview

BACKGROUND

Obesity and gastroesophageal reflux disease (GERD) are commonly associated diseases. Bariatric surgery has been shown to have various impacts on esophageal function and GERD. Our aim was to evaluate changes in symptoms, endoscopic findings, bolus passage and esophageal function in patients after primary gastric bypass surgery as compared to patients converted from gastric banding to gastric bypass.

METHODS

Obese patients scheduled for laparoscopic Roux-en-Y gastric bypass (naïve-to-bypass) and patients who previously underwent gastric banding and were considered for conversion from gastric banding to gastric bypass (band-to-bypass) were included. Patients rated esophageal and epigastric symptoms (100 point VAS) and underwent upper endoscopy, impedance-manometry, and modified "timed barium swallow" before/after surgery.

RESULTS

Data from 66 naïve-to-bypass patients (51/66, 77 % females, mean age 41.2 ± 11.1 years) and 68 band-to-bypass patients (53/68, 78 % females, mean age 43.8 ± 10.0 years) were available for analysis. Esophageal symptoms, esophagitis, esophageal motility abnormalities and impaired esophageal bolus transit were more common in patients that underwent gastric banding compared to those that underwent gastric bypass. The majority of symptoms, lesions and abnormalities induced by gastric banding were decreased by conversion to gastric bypass. Esophagitis was present in 28/68 (41 %) and 13/47 (28 %) patients in the band-to-bypass group, pre- versus postoperatively, respectively, (p < 0.05). The percentage of swallows with normal bolus transit increased following transformation from gastric band to gastric bypass (57.9 ± 4.1 and 83.6 ± 3.4 %, respectively, p < 0.01).

CONCLUSIONS

From an esophageal perspective, gastric bypass surgery induces less motility disorders and esophageal symptoms and should be therefore favored over gastric banding in difficult to treat obese patients at risk of repeated bariatric surgery.

Interest & Impact

Downloads

0 since deposited on 03 May 2017
43 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item