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Is Elective Gastroscopy Prior to Bariatric Surgery in an Asian Cohort Worthwhile?

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Abstract

Background

The preoperative use of gastroscopy for patients undergoing bariatric surgery remains controversial. We aim to evaluate the diagnostic yield of gastroscopy and the clinical significance in asymptomatic individuals undergoing bariatric surgery in Asia.

Methods

We retrospectively reviewed the medical records of all patients undergoing gastroscopy prior to bariatric surgery at the National University Hospital and Khoo Teck Puat Hospital, Singapore, between Jan 2006 and June 2013. Gastroscopy findings were classified into four groups: group 1 (normal study), group 2 (abnormal findings that do not modify surgical approach), group 3 (abnormal findings that modify surgical approach) and group 4 (absolute contraindications to immediate surgery).

Results

During the study period, 208 asymptomatic individuals were evaluated by gastroscopy prior to bariatric surgery. Gastroscopy was normal in 70 (33.6 %). Group 2 comprised 67 (32.2 %) patients with mild gastritis or oesophagitis. Group 3 included 69 (33.2 %) patients diagnosed with erosive gastritis or oesophagitis, peptic ulcer disease, hiatal hernia or mass lesions. There were 2 patients (1.0 %) in group 4. One patient had a gastro-oesophageal junction adenocarcinoma, and 1 had a gastrointestinal stroma tumour. In group 3, modification of surgical approach included concurrent hiatal hernia repair, institution of medical therapy with delay in surgery, further evaluation of mass lesions and change in choice of surgical procedures.

Conclusions

Routine gastroscopy for asymptomatic bariatric patients has a high diagnostic yield. Given the high percentage of patients with clinically important lesions, our current experience supports the use of routine preoperative gastroscopy prior to bariatric surgery in Singapore.

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Author information

Authors and Affiliations

  1. University Surgical Cluster, National University Health System, Level 8 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore

    Jing Yu Ng, Guowei Kim, Davide Lomanto, Jimmy B. Y. So & Asim Shabbir

  2. Department of General Surgery, Khoo Teck Puat Hospital, Yishun, Singapore

    Anton K. S. Cheng

  3. Alexandra Health Services, Yishun, Singapore

    Lucy W. C. Kong

  4. National University of Singapore, Singapore, Singapore

    Khin T. Soe

Authors
  1. Jing Yu Ng
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  2. Anton K. S. Cheng
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  3. Guowei Kim
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  4. Lucy W. C. Kong
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  5. Khin T. Soe
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  6. Davide Lomanto
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  7. Jimmy B. Y. So
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  8. Asim Shabbir
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Corresponding author

Correspondence to Asim Shabbir.

Ethics declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the Research Ethics Committee of the National University Hospital.

For this type of study, formal consent is not required.

Conflict of Interest

The authors declare that they have no conflicts of interest.

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Ng, J.Y., Cheng, A.K.S., Kim, G. et al. Is Elective Gastroscopy Prior to Bariatric Surgery in an Asian Cohort Worthwhile?. OBES SURG 26, 2156–2160 (2016). https://doi.org/10.1007/s11695-016-2060-0

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  • DOI: https://doi.org/10.1007/s11695-016-2060-0

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