Preoperative upper endoscopy is useful before revisional bariatric surgery

Area of Science:

• Bariatric surgery
• Gastroenterology
• Endoscopy

Background:

• Revisional bariatric surgery is complex, with prior procedures including vertical banded gastroplasty, gastric banding, and previous Roux-en-Y gastric bypass.
• Abnormal findings during upper endoscopy in these patients could significantly impact management strategies.

Purpose of the Study:

• To investigate the prevalence and types of upper endoscopy findings in patients undergoing revision to laparoscopic Roux-en-Y gastric bypass.
• To determine if these findings influence patient management and treatment decisions.

Main Methods:

• Retrospective chart review of patients who underwent revision to laparoscopic Roux-en-Y gastric bypass.
• Preoperative upper endoscopy was performed on all patients, with findings systematically recorded.

Main Results:

• Eighty-five percent of 46 patients had abnormal upper endoscopy findings.
• Common findings included gastritis (65%), esophagitis (37%), gastrogastric fistula (11%), and band erosion (11%).
• Sixty-five percent of patients required medical treatment based on endoscopic results.

Conclusions:

• Preoperative upper endoscopy is crucial for identifying abnormalities before revisional bariatric surgery.
• Endoscopy provides vital information on pouch size, anatomy, and the need for preoperative medications.
• Routine preoperative upper endoscopy by the operating surgeon is recommended for all patients undergoing revisional bariatric surgery.