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Wiley InterScience | ||||||||
  Diseases of the EsophagusVolume 20 Issue 5, Pages 420 - 427 Published Online: 5 Jan 2007 © 2010 International Society for Diseases of the Esophagus The Official Journal of the International Society for Diseases of the Esophagus (ISDE) and the European Society of Esophagology (ESE)
Abstract | References | Full Text: HTML, PDF (Size: 115K) | Related Articles | Citation Tracking  Original article Esophageal ileus following laparoscopic fundoplication Copyright © 2007 The Authors Journal compilation © 2007 The International Society for Diseases of the Esophagus KEYWORDS dysphagia • fundoplication • gastroesophageal reflux • ileus • peristalsis ABSTRACTSUMMARY. Early postoperative dysphagia occurs in most patients following laparoscopic fundoplication. Whether dysphagia is associated with a change in esophageal motor function and/or a change in gastroesophageal junction characteristics is unknown. Esophageal motility in the early postoperative period has not been evaluated previously. Esophageal motility was studied on the first postoperative day in 10 patients who underwent laparoscopic Nissen fundoplication and 10 patients who underwent laparoscopic cholecystectomy (control group), using standard perfusion manometry. Primary peristalsis on water swallows following fundoplication elicted a median response of 5% successful peristalsis compared with median response of 100% successful peristalsis following cholecystectomy (P = 0.05). The fundoplication was associated with failure of primary esophageal peristalsis in 7/10 patients, compared to 2/10 patients who underwent cholecystectomy (P = 0.068 Fisher's exact test). Three months after fundoplication, in nine patients studied, primary peristalsis was similar to peristalsis observed preoperatively in seven patients and two patients still had an aperistaltic esophagus. In this study, esophageal manometry 1 day after surgery demonstrated grossly disturbed esophageal motility in most patents following laparoscopic fundoplication, compared to normal motility following laparoscopic cholecystectomy. Peristalsis improved at 3 months or more following surgery. This suggests that an 'esophageal ileus' occurs during the early period after laparoscopic fundoplication. | 
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