Kanat BH, Doğan S. Is gastroscopy necessary before bariatric surgery? World J Gastrointest Endosc 2022; 14(1): 29-34 [PMID: 35116097 DOI: 10.4253/wjge.v14.i1.29]
Corresponding Author of This Article
Burhan Hakan Kanat, MD, Associate Professor, Chief Doctor, Department of General Surgery, Malatya Turgut Özal University, School of Medicine, Alacakapı Mahallesi Kırkgöz Caddesi No. 70, Malatya 44100, Turkey. burhankanat@hotmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Jan 16, 2022; 14(1): 29-34 Published online Jan 16, 2022. doi: 10.4253/wjge.v14.i1.29
Is gastroscopy necessary before bariatric surgery?
Burhan Hakan Kanat, Serhat Doğan
Burhan Hakan Kanat, Serhat Doğan, Department of General Surgery, Malatya Turgut Özal University, School of Medicine, Malatya 44100, Turkey
Author contributions: Kanat BH and Doğan S contributed equally to this work; all authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Burhan Hakan Kanat, MD, Associate Professor, Chief Doctor, Department of General Surgery, Malatya Turgut Özal University, School of Medicine, Alacakapı Mahallesi Kırkgöz Caddesi No. 70, Malatya 44100, Turkey. burhankanat@hotmail.com
Received: February 18, 2021 Peer-review started: February 18, 2021 First decision: May 5, 2021 Revised: May 26, 2021 Accepted: December 22, 2021 Article in press: December 22, 2021 Published online: January 16, 2022
Abstract
Obesity is the abnormal accumulation of fat or adipose tissue in the body. It has become a serious health problem in the world in the last 50 years and is considered a pandemic. Body mass index is a widely used classification. Thus, obese individuals can be easily classified and standardized. Obesity is the second cause of preventable deaths after smoking. Obesity significantly increases mortality and morbidity. We thought of preparing a publication about routine procedures for the preoperative evaluation of obesity. The question that we asked as bariatric and metabolic surgeons but which was not exactly answered in the literature was “Is esophagogastroduodenoscopy (EGD) necessary before bariatric surgery?” We found different answers in our literature review. The European Association of Endoscopic Surgery guidelines recommend EGD for all bariatric procedures. They strongly recommend it for Roux-en-Y gastric bypass (RYGB). As a result of a recent study by the members of the British Obesity & Metabolic Surgery Society, preoperative EGD is routinely recommended for patients undergoing sleeve gastrectomy, even if they are asymptomatic, but not recommended for RYGB. It is recommended for symptomatic patients scheduled for RYGB. According to the International Sleeve Gastrectomy Expert Panel Consensus Statement, preoperative EGD is definitely recommended for patients scheduled for sleeve gastrectomy, but its routine use for RYGB is controversial. However, a different view is that the American Society for Gastrointestinal Endoscopy recommends endoscopy only for symptomatic patients scheduled for bariatric surgery. In the literature, the primary goal of EGD recommended for sleeve gastrectomy has been interpreted as determining esophagitis caused by gastroesophageal reflux. In the light of the literature, it is stated that this procedure is not necessary in America, while it is routinely recommended in the European continent. Considering medicolegal cases that may occur in the future, we are in favor of performing EGD before bariatric surgery. In conclusion, EGD before bariatric surgery is insurance for both patients and physicians. There is a need for larger and prospective studies to reach more precise conclusions on the subject.
Core tip: The European Association of Endoscopic Surgery guidelines recommend esophagogastroduodenoscopy (EGD) for all bariatric procedures. They strongly recommend it for Roux-en-Y gastric bypass (RYGB). The British Obesity & Metabolic Surgery Society recommends routine perioperative EGD for sleeve gastrectomy (SG), even if patients are asymptomatic, but not for RYGB. It is recommended for symptomatic patients scheduled for RYGB. According to the International Sleeve Gastrectomy Expert Panel Consensus Statement, preoperative EGD is definitely recommended for SG, but its routine use for RYGB is controversial. The American Gastrointestinal Endoscopy Association recommends that endoscopy be performed only on symptomatic patients scheduled for bariatric surgery.
