An alternative view on the necessity of EGD before sleeve gastrectomy

Peker, Kevser; Şahbaz, Nuri Alper; Seyit, Hakan; Köneş, Osman; Gumusoglu, Alpen Yahya; Alış, Halil

doi:10.1016/j.soard.2017.06.002

Cited by 12 publications

(5 citation statements)

References 29 publications

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“…Routine gastroscopy in the preoperative period in LSG is a controversial issue. While a group of researchers advocated the necessity of performing routine gastroscopy to each patient preoperatively (26), another group shows a more conservative approach before LSG (27). The fact that we did not encounter any pathology in the gastric lumen in gastroscopy that we performed during the surgery for the lesions we detected incidentally on the stomach wall.…”

Section: Discussionmentioning

confidence: 81%

Unexpected Histopathological Findings After Laparoscopic Sleeve Gastrectomy

Batman¹,

Altun²

2020

Istanbul Med J

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Amaç: Obezite sıklığı tüm dünyada artmaktadır. Laparoskopik sleeve gastrektomi (LSG) günümüzde dünya genelinde en sık uygulanan bariatrik cerrahi olarak yerini almıştır. Diğer bariatrik cerrahilerin aksine LSG'de patolojik inceleme yapılabilecek bir piyes çıkmaktadır. Bu çalışmanın amacı LSG'yi takiben beklenmeyen histopatolojik bulguları tanımlamaktır. Results: One thousand three hundred sixty four patients underwent LSG. The mean age was 40.93±10.86 years; 974 patients (71.48%) were female. The mean BMI was 42.23±7.28. The most common findings in the pathologies were normal gastric specimen (50%), gastritis (30%) and changes due to proton pump inhibitor use (23%) respectively. Conclusion: Gastroscopy should be added to the preoperative preparation process in cases where there is no gastric specimen after the operation. Preoperative gastroscopy is not a necessity for laparoscopic sleeve gastrectomy. It can be performed in selected cases.

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Section: Discussionmentioning

confidence: 81%

Unexpected Histopathological Findings After Laparoscopic Sleeve Gastrectomy

Batman¹,

Altun²

2020

Istanbul Med J

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“…The routine performance of UGE may lead to minimizing complications in the postoperative period, especially related to ulcer perforations or the development of malignancies in ulcers or polyps [ 17 , 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Involvement of Helicobacter pylori in Preoperative Gastric Findings on a Bariatric Population

Gómez-Heras

Fernández-Aceñero

González³

et al. 2022

IJERPH

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The prevalence of Helicobacter pylori (Hp) in bariatric patients is common and related to gastric pathology. With preoperative upper gastrointestinal endoscopy (UGE), these pathologies and the presence of Hp are diagnosed. The histopathological study of the UGE biopsies is classified based on the Sydney System, a scoring system that stages chronic gastritis (CG) and precancerous gastric lesions. The objective is to assess the histological findings of gastric biopsies during routine UGE and to determine the involvement of Hp in gastric disorders in patients undergoing bariatric surgery. A multicenter retrospective review of prospectively collected databases was performed. The presence of CG, gastric atrophy (GA), and gastric intestinal metaplasia (GIM) in the study of the biopsies was assessed and correlated with Hp infection. The incidence of Hp among our bariatric population was 36.1%, and it increases with age. The percentage of patients with severe Hp infection is higher in patients with GA or GIM. The Hp eradication rate is also reduced when GA and GIM are present. A histological examination of all the biopsies did not show features of malignancy in any of the cases. Hp is not the only factor involved in the development of gastric pathology in bariatric patients.

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“…The question remains, whether the EGD for bariatric surgery candidates is a necessity to be performed before the surgical procedure if the patients were found to be asymptomatic upon clinical examination, as some surgeons feel it can delay the surgical procedure and increase the expense and they advocate selective endoscopy in symptomatic patients only [10,11]. On the other hand, many surgeons consider endoscopic evaluation of the upper gastrointestinal tract before surgical alteration with a bariatric procedure is a requirement [12][13][14].…”

Section: Discussionmentioning

confidence: 99%

Preoperative Assessment of Patients Undergoing Bariatric Sleeve Gastrectomy: A Cross-Sectional Study

Tawfik

Aldawas

Almegbil

et al. 2022

Gastroenterology Research and Practice

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Introduction. Saudi Arabia (SA) is one of the top countries in the world when it comes to the number of bariatric procedures performed each year. There is still some debate on whether to do regular or selective upper endoscopy during the preoperative examination. The purpose of this study was to explore various endoscopic findings and Helicobacter pylori (HP) infection in symptomatic and asymptomatic patients having laparoscopic sleeve gastrectomy (LSG) prior to surgery. Methods. We investigated a cohort of 132 patients referred to the endoscopy unit from the bariatric surgery outpatient clinic for prebariatric esophagogastroduodenoscopy (EGD) as a part of preoperative LSG. Data extraction from medical records included clinical data such as body mass index (BMI), gastrointestinal symptoms (that include heartburn, regurgitation, epigastric pain, and nausea), medical comorbidities, and laboratory investigations. It included data about the endoscopic findings of EGD procedure as esophageal, gastric, and duodenal findings results as well as the results of biopsy specimens that were taken. Results. Out of 132 patients, 29 (22%) had a BMI of less than 40 kg/m2 whereas 103 (78%) had a BMI of 40 kg/m2 or above, with an average of 44.4 ± 6.4 kg/m2. The average age of participants was 33.6 ± 10.4 years. HP was detected in 36 patients (35.0%) with a slightly greater prevalence in patients with a higher BMI (33.7%) than in patients with lower BMI (35.0%). Collectively, 73 patients (55.7%) had positive endoscopic findings of various grades, sites, and combinations. Incompetent cardia (35.6%) was the most often seen esophageal finding, antral gastritis (34.1%) was the most frequently encountered gastric finding, and duodenitis 1st part was the commonest duodenal endoscopic finding (7.8%). Among asymptomatic patients, incompetent cardia was detected in 33.3%, antral gastritis was found in 30.1%, and around one-quarter of them were positive on HP testing (26.6%). Additionally, 16.1% of them had signs of reflux esophagitis, 17.2% had hiatal hernia, and 14.0% had nodular gastritis. Conclusion. The current study revealed a high prevalence of positive endoscopic findings as well as HP infection upon routine endoscopic examination among patients undergoing bariatric surgery even those who were asymptomatic from any gastrointestinal symptoms.

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An alternative view on the necessity of EGD before sleeve gastrectomy

Cited by 12 publications

References 29 publications

Unexpected Histopathological Findings After Laparoscopic Sleeve Gastrectomy

Unexpected Histopathological Findings After Laparoscopic Sleeve Gastrectomy

Involvement of Helicobacter pylori in Preoperative Gastric Findings on a Bariatric Population

Preoperative Assessment of Patients Undergoing Bariatric Sleeve Gastrectomy: A Cross-Sectional Study

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