6 CASES OF BARRETTS-ESOPHAGUS AFTER GASTRIC RESTRICTIVE SURGERY FOR MASSIVE OBESITY - AN EXTENDED CASE-REPORT

Objective: The purpose of this study is to report and characterize six patients who have developed Barrett's esophagus after a gastric restr ictive procedure for massive obesity. Method: Retrospective analysis o f patients operated with gastric banding (GB) and vertical banded gast roplasty (VBG) between 1981 and 1994, Results: Four patients (4/92) in itially operated with GB have developed Barrett's esophagus a mean of 9 years post-operatively. Two patients (2/198) operated with VBG devel oped Barrett's esophagus 18 and 47 months postoperatively. The histopa thological type of Barrett's esophagus was cardia-like in three cases, gastric-like in two cases and intestinal-like columnar epithelium in one case. None of the biopsies showed signs of dysplasia. Conclusion: Gastric banding is again gaining popularity with the development of ad justable bands that can be placed laparoscopically. The development of Barrett's esophagus after GB and VBG, a premalignant lesion, is cause for some concern. Prospective long-term studies are needed to further address this complication.