Other patients with dilatation are being followed by interval contrast radiography to assess for regression or possible progression of the esophageal dilatation as they do not desire surgery and/or feel their weight loss is adequate.
Esophageal dysmotility and dilation is a newly recognized complication of LASGB. Intuitively, one might expect an inverse correlation between stomal diameter and esophageal dilation, but none was found. The majority of patients in our study developed new or more severe esophageal symptoms after placement of the device. Other studies support an increase in reflux after gastric banding. Ovrebo found in a study of 17 patients with the so-called "Swedish" LASGB device that acid regurgitation and heartburn increased from approx 15% to 60% after gastric banding. Other authors report complications such as food intolerance unresponsive to band deflation being attributable to pouch dilatation and/or stomal stenosis. Kuzmak, although using a previous version of the current band system, showed that early postoperative contrast study document a pouch dilation rate of 6.5% which increased to 50% over a four year follow-up. Doherty et al found that 38% of patients with an adjustable silicone gastric band required hospitalization for postprandial nausea, vomiting and severe reflux. Radiographically, these patients had enlarged proximal pouches, with delayed or absent pouch emptying and severe reflux. It is unclear if esophageal dysmotility or dilation occurred concurrently with pouch dilation in any of these studies, as these variables were not reported. Perhaps
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