Literature DB >> 18574642

Preoperative endoscopic screening for laparoscopic Roux-en-Y gastric bypass has a low yield for anatomic findings.

Cindy Mong1, Jacques Van Dam, John Morton, Lauren Gerson, Myriam Curet, Subhas Banerjee.   

Abstract

BACKGROUND: Patients undergoing laparoscopic Roux-en-Y bariatric surgery undergo screening esophagoduodenoscopy (EGD) during preoperative evaluation. The hypothesis is to examine the utility of this examination. The purpose of this study was to evaluate the prevalence of clinically significant upper gastrointestinal (UGI) tract findings at screening EGD in patients undergoing laparoscopic Roux-en-Y bariatric surgery. A secondary aim was to determine whether preprocedure symptoms could predict findings at EGD.
METHODS: We evaluated records of patients undergoing EGD prior to bariatric surgery between 2000 and 2005 at the Stanford University Medical Center. Clinical, endoscopic, and pathological data were analyzed. The prevalence of endoscopic findings of clinical significance was determined.
RESULTS: Two hundred seventy two complete patient records were identified and included in the study. Of these, 237 (87%) were female and 197 (72%) were Caucasian. The mean age was 43 +/- 9.68 years and mean body mass index was 48 +/- 7.95 kg/m(2). Of the 272 patients, 33 (12%) had EGD findings of clinical significance including erosive esophagitis (3.7%), Barrett's esophagus (3.7%), gastric ulcers (2.9%), erosive gastritis (1.8%), duodenal ulcers (0.7%), and gastric carcinoid (0.3%). No patients had malignancy. Of these 33 patients, 22 (67%) had UGI symptoms.
CONCLUSIONS: Significant findings at screening EGD were found in 12% of patients. While EGD may be low-yield, the findings could be useful in guiding clinical decision making.

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Year:  2008        PMID: 18574642     DOI: 10.1007/s11695-008-9600-1

Source DB:  PubMed          Journal:  Obes Surg        ISSN: 0960-8923            Impact factor:   4.129


  26 in total

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4.  Obesity surgery: evidence-based guidelines of the European Association for Endoscopic Surgery (EAES).

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5.  Obesity is associated with increased risk of gastrointestinal symptoms: a population-based study.

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6.  Monitored anesthesia care with propofol versus surgeon-monitored sedation with benzodiazepines and narcotics for preoperative endoscopy in the morbidly obese.

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9.  Flexible endoscopy in the management of patients undergoing Roux-en-Y gastric bypass.

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  14 in total

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Authors: 
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3.  Current Status of Preoperative Oesophago-Gastro-Duodenoscopy (OGD) in Bariatric NHS Units-a BOMSS Survey.

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4.  Is Preoperative Upper Gastrointestinal Endoscopy in Obese Patients Undergoing Bariatric Surgery Mandatory? An Asian Perspective.

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Review 7.  Gastrointestinal Symptomatology as a Predictor of Esophagogastroduodenoscopy Findings in the Bariatric Population: a Retrospective Cohort Study with Review of the Literature.

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8.  Is routine preoperative upper GI endoscopy needed prior to gastric bypass?

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Review 9.  Benign, premalignant, and malignant lesions encountered in bariatric surgery.

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