外科ジャーナル

Upper Digestive Endoscopy Prior to Bariatric Surgery in Morbidly Obese Patients - A Retrospective Analysis

Abstract

Roxana Maria Livadariu,Daniel Timofte, Lidia Ionescu, Radu Dănilă, Vasile Drug, and Anca Trifan

Aim: Obesity has become one of the world’s major public health problems. It is now accepted that bariatric surgery is a far better option than nonsurgical treatments for morbid obese patients. Routine upper gastrointestinal (GI) endoscopy as a complementary method for evaluation of bariatric patient’s status prior to surgery is still a matter of debate. Aim of the study was to evaluate the importance of routine upper GI endoscopy before bariatric surgery.

Material and methods: A clinical retrospective study was carried out on a series of 77 patients referred for bariatric surgery between 2012 and 2015 in our surgical unit. We reviewed the medical records of all patients, endoscopy diagnosis, histopatological reports on gastric endoscopic biopsies and the colonisation with H. pylori.

Result: The patients in our study had a median age of 39.25 years and a BMI (body mass index) ranging from 33.3 to 60.5 kg/m2 (median of 44.66 kg/m2). Upper GI endoscopy was performed in all patients before bariatric surgery, regardless of upper gastrointestinal simptomatology. Chronic gastritis was found on upper GI endoscopy prior to bariatric surgery in 36.3% of cases and Helicobacter pylori infection was identified in 26% of cases. 6.5% of the patients were diagnosed with hiatal hernia, a hyperplastic gastric polyp, a intragastric pancreatic tissue ectopy and a case of gastric cancer were also detected.

Conclusion: Although preoperative endoscopy rarely diagnose pathological conditions that may change the surgical approach, we believe that, for a complete work-out of these patients, gastroenterology consultation and upper GI endoscopy should be mandatory prior to bariatric surgery.