Abstract
Background:
The aim of the present study was to investigate and discuss the incidence of gastric anomalies and pathologies among bariatric surgery patients who underwent preoperative endoscopic evaluation.
Methods:
Between March 2013 and March 2015, a series of obese patients, who underwent esophagogastroduodenoscopy (EGD) before bariatric surgery (sleeve gastrectomy or Roux-en-Y gastric bypass), were enrolled in the study. The demographic features, endoscopic diagnoses, gastric biopsies, and surgical data were retrospectively evaluated.
Results:
The study included 157 patients (108 female and 49 male) with a mean age of 43 years. The mean body mass index was 48 kg/m2. Abnormal findings were observed in 67% of the patients of whom only 17% were symptomatic. Endoscopic findings were as follows: gastritis: 54%, esophagitis: 10%, hiatal hernia: 17%, gastric ulcer: 5%, and others: 3%. Helicobacter pylori infection was investigated in 125 patients and detected in 62%. Gastric biopsies were performed in 148 patients, with chronic inflammation found in 65%, inflammatory activity in 32%, and intestinal metaplasia in 2%. While endoscopic findings changed medical management or delayed surgical procedure in 54% of the patients, it altered the surgical procedure in one patient due to heterotopic pancreatic tissue.
Conclusion:
The results of our study show that there is a broad spectrum of gastrointestinal diseases (67%) with an impact on perioperative management in over half of the obese patients (54%). Given the high diagnostic yield of gastric disorders from our findings, we recommend routine EGD for patients scheduled to undergo bariatric surgery.
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