Evaluation of Upper Gastrointestinal Endoscopy in Patients Undergoing Bariatric Surgery

Abstract

Background: Obesity has become epidemic, and is associated with greater morbidity and mortality. Treatment is multidisciplinary. Surgical treatment is a consistent resource in severe obesity. The indication of preoperative upper gastrointestinal endoscopy in asymptomatic patients is controversial; however, most studies recommend its implementation in all patients. Aim: To analyze endoscopic performance in patients who were in preoperative for bariatric surgery and compare them with control group. Method: A series of 35 obese patients in preoperative period for bariatric surgery compared with a control group of 30 patients submitted to upper endoscopy. There were analyzed clinical and endoscopic data. Results: The mean age of the group of patients was 43.54 years. Most individuals in the group of patients were female with median BMI of 47.26kg/m2and in control group 24.21 kg/m2. The majority of patients were asymptomatic. Upper endoscopy was altered in 81.25% of asymptomatic patients. Endoscopic findings in the patient group were 57.1% resulting from peptic ulcer disease and 34.3% associated with GERD. The analysis of endoscopic findings in patients showed no significant difference in relation of the control group. The prevalence of H. pylori infection was 60% in patients. Conclusion: It is recommended that the upper endoscopy should be made in all patients in the preoperative bariatric surgery period, although the degree of obesity is not related to a greater number of endoscopic findings. Obese patients do not have more endoscopic findings that non-obese individuals.

Gastric and Jejunal Histopathological Changes in Patients Undergoing Bariatric Surgery

“…Despite the increased performance of bariatric surgery in recent years, few studies have investigated the histologic changes in the gastric mucosa of obese patients before surgery and in the mucosa of the Roux-en-Y anastomosis after surgery 1 , 22 , 24 .…”

Role of Preoperative Esophagogastroduodenoscopy (EGD) in Bariatric Treatment

“…An advantage of EGD is the possibility of visualizing esophageal, gastric, and duodenal mucosa, and with the evaluation for Helicobacter pylori infection, inflammation, and potential neoplastic lesions. In addition, the complication rate after EGD is approximately 1% [26][27][28]. Examination can provide additional information that warrants qualification for bariatric surgery, selection of its type, and necessity of concomitant surgical procedures (e.g., hiatal hernia repair) and preoperative treatment (e.g., eradication of Helicobacter pylori).…”