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The Role of Routine Upper Gastrointestinal Endoscopy Before Bariatric Surgery

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Abstract

Background

Obesity remains a major health concern for which surgery has proven to be the most effective treatment in the long term. Routine upper gastrointestinal endoscopy (UGE) is recommended before surgery, but few studies have evaluated its impact on postoperative complications.

Methods

We studied a cohort of 613 patients submitted to UGE before being listed for bariatric surgery between May 2004 and May 2015. A logistic regression analysis was performed to evaluate potential predictors of postoperative complications.

Results

Three hundred forty-five patients (56.3 %) presented abnormal endoscopic findings. Helicobacter pylori (Hp) was the strongest predictor of an abnormal endoscopy (OR 10.343, 95 % CI [3.970–26.943], p < 0.001). Of the 342 patients who underwent surgery, 43 (12.6%) developed a postsurgical complication and 2 (0.6%) patients died. In regression analysis, endoscopic ulceration was the only predictor of postoperative complications (OR 11.10, 95 % CI [1.80–68.467], p = 0.01). All patients with gastroduodenal ulcers were infected with Hp.

Conclusions

UGE before bariatric surgery can identify a wide range of abnormal findings. Gastric and duodenal ulcers appear to be the major findings associated with postoperative complications. Routine Hp eradication may potentially reduce the risk of postoperative complications and should be attempted in all patients before surgery.

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Author Contributions

Samuel R. Fernandes, MD and Liliane C. Meireles, MD made the preparation and critical review of the manuscript. Luís Carrilho-Ribeiro, MD PhD and José Velosa, MD PhD did critical review of the manuscript.

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Authors and Affiliations

  1. Serviço de Gastrenterologia e Hepatologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Avenida Professor Egas Moniz, Lisbon, 1649-035, Portugal

    Samuel R. Fernandes, Liliane C. Meireles, Luís Carrilho-Ribeiro & José Velosa

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  1. Samuel R. Fernandes
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  2. Liliane C. Meireles
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Correspondence to Samuel R. Fernandes.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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The authors declare that they have no competing interests.

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Fernandes, S.R., Meireles, L.C., Carrilho-Ribeiro, L. et al. The Role of Routine Upper Gastrointestinal Endoscopy Before Bariatric Surgery. OBES SURG 26, 2105–2110 (2016). https://doi.org/10.1007/s11695-016-2056-9

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