Six Cases of Barrett's 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 restrictive procedure for massive obesity. METHOD: Retrospective analysis of patients operated with gastric banding (GB) and vertical banded gastroplasty (VBG) between 1981 and 1994. RESULTS: Four patients (4/92) initially operated with GB have developed Barrett's esophagus a mean of 9 years post-operatively. Two patients (2/198) operated with VBG developed Barrett's esophagus 18 and 47 months postoperatively. The histopathological 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 adjustable 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.