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Upper Gastrointestinal Endoscopy prior to Bariatric Surgery-Mandatory or Expendable? An Analysis of 801 Cases

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Abstract

Background

Upper gastrointestinal pathologies are common in bariatric patients. Preoperative esophagogastroduodenal endoscopy (EGD) should detect and treat pathologies that might alter the type of bariatric surgery. However, clinical consequences of these findings are often insignificant. The aim of this study was to assess the influence of preoperative endoscopy in our cohort and its clinical consequences.

Methods

We conducted a retrospective analysis of endoscopic findings in patients under evaluation for bariatric surgery. Endoscopic findings were compared to preoperative risk factors as well as postoperative complications, and its clinical consequences were analyzed.

Results

Data was available for 801 patients. Abnormal endoscopic findings were found in 65.7% of all patients. The most common conditions were gastritis (32.1%) and gastroesophageal reflux (24.8%). Malignancies were observed in 0.5% of all patients. We observed early-stage adenocarcinoma of the esophagus in two patients through our routine preoperative evaluation. Helicobacter pylori infections were detected in preoperative biopsies in only 3.7% of all patients. Patients who reported reflux symptoms had a higher rate of pathological EGDs (74.2 vs. 64.9%, p .019). We did not find any other risk factors for a pathological endoscopy. The postoperative complication rate was 11.2%. Leakage rate was 1.1%. Mortality rate was 0.4%. We did not find any correlation between the incidence of postoperative complications and preoperative endoscopic findings.

Conclusions

Relevant findings in routine preoperative endoscopy are rare but have significant influence on decision-making in bariatric patients and should be assessed as a necessary diagnostic tool.

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Authors and Affiliations

  1. Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany

    Stefan Wolter, Anna Duprée, Jameel Miro, Cornelia Schroeder, Marie-Isabelle Jansen, Jakob Izbicki, Oliver Mann & Philipp Busch

  2. Department of Endocrinology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Clarissa Schulze-zur-Wiesch

  3. Department of Endoscopy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Stefan Groth

Authors
  1. Stefan Wolter
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  2. Anna Duprée
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  3. Jameel Miro
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  4. Cornelia Schroeder
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  5. Marie-Isabelle Jansen
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  6. Clarissa Schulze-zur-Wiesch
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  7. Stefan Groth
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  8. Jakob Izbicki
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  9. Oliver Mann
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  10. Philipp Busch
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Corresponding author

Correspondence to Stefan Wolter.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures were in accordance with good clinical practice and within the guidelines of the Declaration of Helsinki. Written informed consent was obtained from all patients.

Supportive Foundations

There was no funding in the development of this article. No grants or fellowships were used to support the paper.

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Wolter, S., Duprée, A., Miro, J. et al. Upper Gastrointestinal Endoscopy prior to Bariatric Surgery-Mandatory or Expendable? An Analysis of 801 Cases. OBES SURG 27, 1938–1943 (2017). https://doi.org/10.1007/s11695-017-2622-9

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  • DOI: https://doi.org/10.1007/s11695-017-2622-9

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