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Erschienen in: Surgical Endoscopy 2/2017

10.06.2016

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

verfasst von: Jan Borovicka, Claudia Krieger-Grübel, Boudewijn van der Weg, Martin Thurnheer, Bernd Schultes, Michael Christian Sulz, Jean-Pierre Gutzwiler, Philipp Bisang, Daniel Pohl, Michael Fried, Christa Meyenberger, Radu Tutuian

Erschienen in: Surgical Endoscopy | Ausgabe 2/2017

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Abstract

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.
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Metadaten
Titel
Effect of morbid obesity, gastric banding and gastric bypass on esophageal symptoms, mucosa and function
verfasst von
Jan Borovicka
Claudia Krieger-Grübel
Boudewijn van der Weg
Martin Thurnheer
Bernd Schultes
Michael Christian Sulz
Jean-Pierre Gutzwiler
Philipp Bisang
Daniel Pohl
Michael Fried
Christa Meyenberger
Radu Tutuian
Publikationsdatum
10.06.2016
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 2/2017
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-016-4996-5

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