Role of upper gastrointestinal endoscopy before bariatric surgery

Abstract

Background: The ultimate purpose of weight management in patients with obesity is to reduce the risk of related comorbidities and improve their health. Bariatric surgery appears to be cost-effective compared with the standard intervention in the management of morbid obesity. However, the role of preoperative esophagogastroduodenoscopy (EGD) remains a controversial topic. The aim of this study is to assess the incidence of abnormal findings in preoperative EGD, to evaluate the correlation between EGD findings and patient risk factors, and to evaluate EGD’s effects on the surgical management plan. Materials and Methods: A retrospective cross-sectional study was conducted on all patients who underwent bariatric surgery at Al-Hada Military Hospital, Taif, Saudi Arabia, by reviewing their medical records. Result: The study population included 227 patients (26% males and 74% females). The incidence of abnormal EGD findings was 78.9% (n = 179), and the most common result was gastritis (n = 86; 37.9%). The prevalence of this abnormal EGD finding was significantly higher in males (n = 53; 89.8%) than in females (n = 126; 75%) (P = 0.016). A multivariate logistic regression analysis showed that male sex (odds ratio [OR] = 3.11 [95% confidence interval (CI) = 1.08–8.93]; P value = 0.036) and hypothyroidism (OR = 2.39 [95% CI = 1.02–5.59]; P value = 0.044) were independent predictive factors for abnormal EGD findings. Conclusion: Almost 80% of patients who underwent EGD before bariatric surgery had abnormal findings including Helicobacter pylori infection, gastritis, hiatal hernia, or duodenitis. Nevertheless, surgical management plans were not significantly impacted by those findings. Accordingly, preoperative EGD should be performed as clinically indicated.