Hospices Civils de Lyon, Edouard Herriot Hospital, Digestive Physiology, Lyon, France.
Dig Liver Dis. 2011 Feb;43(2):116-20. doi: 10.1016/j.dld.2010.08.011. Epub 2010 Oct 12.
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).
Twenty-two LAGB patients with esophageal symptoms (dysphagia, vomiting, and regurgitations) were included. Esophageal motility was studied using HRM (ManoScan®, Sierra Systems) and classified according to the Chicago classification.
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).
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.
腹腔镜胃束带术（LAGB）后常出现吞咽困难和呕吐。这些症状可能继发于食管动力障碍。我们的目的是使用高分辨率测压法（HRM）评估有食管症状的 LAGB 患者的食管动力和清除功能。
纳入 22 例有食管症状（吞咽困难、呕吐和反流）的 LAGB 患者。使用 HRM（ManoScan®，Sierra Systems）研究食管动力，并根据芝加哥分类进行分类。
手术与测压评估之间的中位时间为 6.3 年（范围 1-10 年）。仅有 2 例患者的测压数据被认为正常。3 例诊断为贲门失弛缓症，15 例功能性食管下括约肌梗阻，2 例低压力蠕动。6 例患者在吞咽时出现全食管压力升高，7 例出现食管裂孔疝压力升高，2 例出现胃囊压力升高。18 例患者的腔内压力升高。6 例 LAGB 被放气，12 例被移除。在 LAGB 移除后症状无变化的 2 例患者中，动力障碍仍然存在（1 例贲门失弛缓症，1 例功能性食管下括约肌梗阻）。
在有症状的 LAGB 患者中，食管动力障碍很常见。高分辨率测压法可评估食管清除功能，并为治疗选择提供指导。
