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Is Routine Preoperative Esophagogastroduodenscopy Screening Necessary Prior to Laparoscopic Sleeve Gastrectomy? Review of 1555 Cases and Comparison with Current Literature

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An Erratum to this article was published on 26 July 2017

This article has been updated

Abstract

Background

Controversy exists as to whether routine preoperative esophagogastroduodenoscopy (p-OGD) in bariatric surgery should be routinely undertaken or undertaken selectively based on patients’ symptoms. As very few studies have focused on the role of p-OGD prior to the increasingly common laparoscopic sleeve gastrectomy (LSG), we assessed the role/impact of p-OGD in LSG patients.

Methods

Retrospective review of records of all LSG patients operated upon at Hamad General Hospital, Qatar (2011–2014, n = 1555). All patients were screened by p-OGD. Patient characteristics were analyzed, and p-OGD findings were categorized into four groups employing Sharaf et al.’s classification (Obes Surg 14:1367–1372, 23). We assessed the impact of p-OGD findings on any change in surgical management or lack thereof.

Results

p-OGD findings indicated that 89.5% of our patients had normal or mild findings and were asymptomatic (groups 0 and 1, not necessitating any change in surgical management), and no patients had gastric cancer or varices (group 3). A total of 10.5% of our sample were categorized as group 2 patients who, according to Sharaf et al. (Obes Surg 14:1367–1372, 23), might have their surgical approach changed. All patients diagnosed preoperatively with hiatal hernia (HH) had LSG with crural repair and their symptoms resolved postoperatively.

Conclusion

Due to effectiveness and best utilization of resources, routine p-OGD screening in patients scheduled for LSG may require further justification for asymptomatic patients especially in regions with low upper GI cancers. p-OGD findings had low impact on the management of asymptomatic patients. Crural repair plus LSG was effective for hiatal hernia.

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Change history

  • 26 July 2017

    An erratum to this article has been published.

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Author information

Authors and Affiliations

  1. Department of Bariatric Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar

    Asaad Salama, Mohsen Karam & Moataz Bashah

  2. Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar

    Tamer Saafan

  3. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar

    Walid El Ansari

Authors
  1. Asaad Salama
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  2. Tamer Saafan
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  3. Walid El Ansari
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  4. Mohsen Karam
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  5. Moataz Bashah
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Correspondence to Asaad Salama.

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Statement of Informed Consent

Does not apply. The informed consent was waived (IRB-approved, HIPAA-compliant retrospective study).

Statement of Human and Animal Rights

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.

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For this type of study, formal consent is not required as it is a retrospective study.

Conflict of Interest

The authors declare that they have no conflict of interest.

Additional information

An erratum to this article is available at https://doi.org/10.1007/s11695-017-2837-9.

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Salama, A., Saafan, T., El Ansari, W. et al. Is Routine Preoperative Esophagogastroduodenscopy Screening Necessary Prior to Laparoscopic Sleeve Gastrectomy? Review of 1555 Cases and Comparison with Current Literature. OBES SURG 28, 52–60 (2018). https://doi.org/10.1007/s11695-017-2813-4

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