• Skip to primary navigation
  • Skip to main content
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • SAGES Store
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
    • “Unofficial” Logo Products
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2024 Scientific Session Call For Abstracts
      • 2024 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • Wellness Resources – You Are Not Alone
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Fellows Career Development Course
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES Top 21 MIS Procedures
    • SAGES Pearls
    • SAGES Flexible Endoscopy 101
    • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • OWLS
  • Log In

Does Preoperative Endoscopy in Bariatric Surgery Alter the Medical or Surgical Strategy?

Introduction: Controversy exists as to the need for preoperative esophago-gastro-duodenoscopy (EGD) for patients undergoing bariatric surgery. Specifically, do findings alter the medical and surgical management. The purpose of this study is to evaluate the role of preoperative EGD in the therapeutic strategy of bariatric surgery.

Methods: We conducted a retrospective analysis of consecutive patients undergoing bariatric surgery over an 18 month period (2006-2008). A total of 69 patients were reviewed and all patients underwent preoperative EGD prior to surgery.

Results: 14/69 patients underwent primary procedures (laparoscopic sleeve gastrectomy (LSG) or roux-en-y gastric bypass (LRYGB)) and 55/69 underwent a revision of a previous bariatric surgery to LSG or LRYGB. The findings included biopsy-proven H Pylori presence in 4 (2.7%), gastritis in 18 (12.4%), esophagitis in 14 (9.6%), hiatal hernias in 12 (8.2%), gastric polyps in 7 (4.8%), duodenal polyp in 2 (1.3%), and a duodenal lieomyoma in one patient (0.69%). 25 patients (17.2%) had no clinico-pathological findings. 11/55 (20.0%) of the patients that had previous bariatric procedures were found to have eroded bands on preoperative EGD. 8/11 bands were removed endoscopically and 3/11 were removed surgically. Preoperative endoscopy resulted in change in management in 16/69 patients (23.1%); 7/16 patients were from the primary bariatric group and 9/16 from the revisional group. Of the 7 primary group patients, 4 required H pylori treatment preoperatively, 2 required concurrent hiatal hernia repair, and 1 patient with duodenal lieomyoma underwent LSG instead of the planned LRYGB to allow surveillance. In the revision group, the operative strategy was changed from LRYGB to LSG following preoperative endoscopy in 6/9 patients. The operative strategy was changed to trans-gastric/laparoscopic in the 3 patients that required surgical removal of eroded bands.

Conclusion: Surgical strategies are significantly more affected by preoperative EGD in revisional bariatric cases as compared to primary bariatric procedures. Regardless, preoperative EGD is essential in both primary and revisional bariatric surgery since the management is altered in a large proportion of cases.


Session: Podium Presentation

Program Number: S105

95

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064
1-310-437-0544
[email protected]
Monday - Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube
  • Instagram
  • TikTok

Important Links

SAGES 2024 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons