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Effects of adjustable gastric banding on gastroesophageal reflux and esophageal motility: a systematic review
Author(s) -
De Jong J. R.,
Besselink M. G. H.,
Van Ramshorst B.,
Gooszen H. G.,
Smout A. J. P. M.
Publication year - 2010
Publication title -
obesity reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.845
H-Index - 162
eISSN - 1467-789X
pISSN - 1467-7881
DOI - 10.1111/j.1467-789x.2009.00622.x
Subject(s) - reflux , medicine , reflux esophagitis , gastroenterology , esophagitis , esophageal sphincter , pathological , disease
Summary Controversial opinions exist concerning the effect of laparoscopic adjustable gastric banding on gastroesophageal reflux. MEDLINE and EMBASE databases were searched for relevant studies on patients undergoing adjustable gastric banding. Data are expressed in mean (range). Twenty studies were identified with a total of 3307 patients. The prevalence of reflux symptoms decreased postoperatively from 32.9% (16–57) to 7.7% (0–26.9) and medication use from 27.5% (16–38.5) to 9.5% (3.1–19.2). Newly developed reflux symptoms were found in 15% (6.1–20) of the patients. The percentage of esophagitis decreased postoperatively from 33.3% (19.4–61.6) to 27% (2.3–60.8). Newly developed esophagitis was observed in 22.9% (0–38.4). Pathological reflux was found in 55.8% (34.9–77.4) preoperatively and postoperatively in 29.4% (0–41.7) of the patients. Lower esophageal sphincter pressures increased from 12.9 to 16.9 mmHg (11.3–21.4). Lower esophageal sphincter relaxation decreased from 100% to 79.7% (58–86). The percentage of dysmotility increased from 3.5% (0–10) to 12.6% (0–25). Adjustable gastric banding has anti‐reflux properties resulting in resolution or improvement of reflux symptoms, normalized pH monitoring results and a decrease of esophagitis on short term. However, worsening or newly developed reflux symptoms and esophagitis are found in a subset of patients during longer follow‐up.