Place of upper endoscopy before and after bariatric surgery: A multicenter experience with 3219 patients

Core Tip

Core tip: It is still a major controversial point to do routine screening endoscopy for obese patients before surgery. Many authors suggest doing upper esophagogastroduodenoscopy (EGD) for all patients before bariatric procedures because of the lack of correlation between patient symptoms and EGD findings. On the contrary, many other investigators advocate selective approach for asymptomatic patients because of the relatively weak clinical relevance of the majority of the lesions discovered on routine EGD along with the cost and invasiveness of the EGD. The upper endoscopy is commonly indicated in the postoperative bariatric patient to evaluate post-bariatric symptoms, to detect and manage complications, as well as evaluation of failure of weight loss. Post-bariatric complications prompting upper endoscopy include bleeding, anastomotic or staple line leaks or fistulae, sleeve stricture in laparoscopic sleeve gastrectomy or stomal stenosis in laparoscopic Roux en Y gastric bypass, or laparoscopic minigastric bypass. We aimed in this retrospective study to answer if it is still necessary to do pre-bariatric screening endoscopy and to evaluate the efficacy and safety of the endoscopic therapy for management of post-bariatric complications.