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Clinical significance of upper gastrointestinal endoscopy before laparoscopic bariatric procedures in Japanese patients

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Abstract

Purposes

The choice between performing routine and selective upper gastrointestinal endoscopy (UGE) before bariatric surgery remains controversial. This study aimed to evaluate the clinical significance of UGE before laparoscopic bariatric procedures.

Methods

We enrolled 155 obese Japanese patients who underwent laparoscopic bariatric procedures at our institute and evaluated their endoscopic findings, such as reflux esophagitis (RE), hiatal hernia (HH), Barrett’s esophagus, gastritis, duodenitis, gastroduodenal ulcer, gastric cancer, and polyps.

Results

Preoperative endoscopy revealed abnormal findings in 102 patients (66%), including gastritis in 57 (37%), HH in 51 (32%), RE in 27 (17%), benign gastric polyps in 16 (10%), duodenitis in 6 (4%), and Barrett’s esophagus in 1 (0.6%). Two patients with definite HH were treated with simultaneous crural repair at the time of bariatric surgery. Duodenitis was graded as severe in three of these six patients and treated with a proton pump inhibitor before surgery. Eleven patients received therapy to eradicate Helicobacter pylori (H. pylori), either before or after the surgery. In summary, preoperative endoscopy changed the perioperative management for 16 of the 155 patients (10%).

Conclusions

Routine UGE may be necessary before bariatric procedures in obese Japanese patients.

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Authors and Affiliations

  1. Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, 1-1 Idaigaoka Hasama-machi, Yufu, Oita, 8795593, Japan

    Yuichi Endo, Masayuki Ohta, Kazuhiro Tada, Kunihiro Saga, Hiroomi Takayama, Teijiro Hirashita, Hiroki Uchida, Yukio Iwashita & Masafumi Inomata

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  1. Yuichi Endo
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  2. Masayuki Ohta
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  3. Kazuhiro Tada
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  9. Masafumi Inomata
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Correspondence to Yuichi Endo.

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Yuichi Endo and his co-authors have no conflicts of interest to declare.

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Endo, Y., Ohta, M., Tada, K. et al. Clinical significance of upper gastrointestinal endoscopy before laparoscopic bariatric procedures in Japanese patients. Surg Today 49, 27–31 (2019). https://doi.org/10.1007/s00595-018-1705-0

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