Role of routine upper endoscopy before bariatric surgery in the Middle East population: a review of 1278 patients

Abstract

Introduction The routine use of preoperative endoscopy for patients undergoing bariatric surgery is controversial. Although many surgeons find it unnecessary, others still consider it a mandatory tool in preoperative assessment. Patients and methods We reviewed the medical records of all patients who had undergone preoperative endoscopy before bariatric surgery in Rashid Hospital between January 2013 and June 2016. The patients were divided into three groups: Group 0 included patients with normal endoscopy; Group 1 included patients with abnormalities that did not affect the timing or type of procedure; Group 2 included patients with abnormalities that had a direct impact on the procedure. Results The files of 1473 patients were reviewed. Endoscopy results were not present in 195 files, so those patients were excluded, and the remaining 1278 files were included. The mean age of patients was 41.3 ± 12.7 years, 61 % were female and 39 % were male. The mean body mass index (BMI) was 43.7 ± 8 kg/m2. Endoscopy was normal in 10.6 % of patients and abnormal in 89.4 %. The most common abnormalities were gastritis, positive Campylobacter-like organism test (CLO test), gastroesophageal reflux disease (GERD) with esophagitis and hiatal hernia. Group 0 included 10.6 % of patients (n = 135), Group 1 included 25.6 % of patients (n = 327), while Group 2 included 63.8 % of patients (n = 816). Conclusion Routine endoscopy seems to play an important part in the preoperative preparation of patients planned for bariatric surgery in the Middle East population. Further studies or meta-analysis could help in building up clear solid evidence and guidelines that could be approved by international bariatric associations with regard to indications for preoperative upper endoscopy in bariatric patients.