Is Preoperative Esophagoduodenoscopy Required in all Patients Prior to Bariatric Surgery?

Abstract

Introduction:

Globally, the number of bariatric operations is steadily increasing. It has also been proven that obesity is associated with several diseases of the upper gastrointestinal tract. However, it remains unclear whether the preoperative diagnostic work-up prior to bariatric procedures should generally include esophagogastroduodenoscopy (EGD). The aim of this study is to clarify if subgroups of patients planned for bariatric surgery benefit from preoperative EGD.

Methods:

This retrospective study included 264 consecutive patients undergoing primary gastric bypass (199) or sleeve gastrectomy (65) between January 2004 and June 2012. EGD was performed in all patients before surgery. In patients with pathological findings (n = 220), a histological sample was obtained and analyzed.

Results:

Pathological findings were present in 79.1% of patients. The majority (78%) showed gastritis without clinical significance. These pathological findings were independent from the patients' body mass index, age, or sex.

Conclusions:

Although preoperative EGD revealed pathological findings in a large proportion of patients, the vast majority of these findings did not lead to a change in clinical management. No subgroups could be determined who especially benefit from EGD. These data do not support an unrestricted recommendation of performing EGD in asymptomatic bariatric patients prior to surgery.