Obesity Surgery

, 17:28

Endoscopic and Histologic Findings of the Foregut in 426 Patients with Morbid Obesity

  • Attila Csendes
  • Ana Maria Burgos
  • Gladys Smok
  • Marcelo Beltran
Article

DOI: 10.1007/s11695-007-9002-9

Cite this article as:
Csendes, A., Burgos, A.M., Smok, G. et al. OBES SURG (2007) 17: 28. doi:10.1007/s11695-007-9002-9

Background

Roux-en-Y gastric bypass is the most frequent bariatric operation. In this operation, the distal bypassed stomach is left in situ. We studied preoperative clinical, endoscopic and histologic findings in a consecutive group of morbidly obese patients prior to bariatric surgery.

Methods

A prospective study was conducted from August 1999 until May 2004, which consisted of 426 patients with morbid obesity. There were 94 men and 332 women, with mean age 39.5 years. In all patients prior to surgery, upper endoscopy was performed and biopsy samples were taken distal to squamo-columnar junction (cardiac biopsies), and in 232 of them also in at the antrum.

Results

Pathological findings at the esophagus were seen in 55% of the patients, mainly related to reflux esophagitis. Barrett’s esophagus was seen in 5.8%. In the stomach, pathological findings were seen in 32% of the patients. Active peptic ulcer was demonstrated in 2.6% of the cases. At the duodenum, pathologic findings were detected in 13.4% of the patients, showing an ulcer in 2.6%. At the stomach, chronic inactive gastritis and atrophic gastritis with intestinal metaplasia were found in 8.6% and 6.5% respectively. Antral adenoma with low-grade dysplasia was found in 1 patient, and 1 carcinoid tumor. H. pylori was present in 53% of the patients, mainly in the antrum.

Conclusion

In candidates for bariatric surgery, upper endoscopy with biopsy samples and determination of H. pylori should be routinely performed. If present, H. pylorishould be eradicated. After surgery, if Barrett’s esophagus was present, endoscopic surveillance is recommended.

Key words

Bariatric surgery morbid obesity gastric bypass gastroscopy 

Copyright information

© Springer Science + Business Media B.V. 2007

Authors and Affiliations

  • Attila Csendes
    • 1
  • Ana Maria Burgos
    • 1
  • Gladys Smok
    • 1
  • Marcelo Beltran
    • 1
  1. 1.Department of SurgeryClinical Hospital University of ChileSantiagoChile