High resolution esophageal manometry evaluation in symptomatic patients after gastric banding for morbid obesity

作者：Cruiziat Claire; Roman Sabine; Robert Maud; Espalieu Philippe; Laville Martine; Poncet Gilles; Gouillat Christian; Mion Francois^*

来源：Digestive and Liver Disease, 2011, 43(2): 116-120.

DOI：10.1016/j.dld.2010.08.011

• Esophageal high resolution manometry
• Gastric banding

Background: Dysphagia and vomiting are frequent after laparoscopic gastric banding (LAGB). These symptoms could be secondary to esophageal motility disorders. Our aim was to assess esophageal motility and clearance in symptomatic LAGB patients using high resolution manometry (HRM).
Methods: Twenty-two LAGB patients with esophageal symptoms (dysphagia, vomiting, and regurgitations) were included. Esophageal motility was studied using HRM (ManoScan (R), Sierra Systems) and classified according to the Chicago classification.
Results: The median delay between surgery and manometry evaluation was 6.3 years (range 1-10). Manometric data were considered as normal in only 2 patients. Achalasia was diagnosed in 3 cases, functional EGJ obstruction in 15, hypotensive peristalsis in 2. During swallowing pan-esophageal pressurization was observed in 6 patients, hiatal hernia pressurization in 7 and gastric pouch pressurization in 2. The intra-bolus pressure was elevated in 18 patients. LAGB was deflated in 6 patients and removed in 12. In 2 patients with unchanged symptoms after LAGB removal motility disorders persisted (1 achalasia, 1 functional EGJ obstruction).
Conclusion: In symptomatic LAGB patients, esophageal dysmotility is frequent. High resolution manometry allows the assessment of esophageal clearance and provides guidance for the choice of treatment.

• 出版日期2011-2