Routine Screening Endoscopy before Bariatric Surgery: Is It Necessary?

Routine esophagogastroduodenoscopy (EGD) prior to bariatric surgery has not been consistently shown to change the management of the patient. A study was performed to estimate the proportion of patients undergoing bariatric surgery evaluation who had abnormal findings on preoperative EGD that resulted in alteration of management and, second, to evaluate potential risk factors for occurrence of abnormal findings on the EGD. An observational, retrospective study in which all 232 patients who were cleared to undergo bariatric surgery and who underwent preoperative EGD between 2006 and 2013 were included at a single tertiary dedicated bariatric center for weight loss management. Abnormal findings on screening EGD and medical or surgical management alteration based on the EGD findings were reviewed. Abnormal findings on screening EGD were found in 143 patients (61.6%). Thirty-five patients had medical management altered (15.1%), while four patients (1.7%) had surgical management altered. Being aged >55 years and the presence of gastroesophageal reflux disease were associated with occurrence of an abnormal finding on screening EGD. While abnormalities on preoperative EGD are often found in patients undergoing bariatric surgery evaluation, rarely do the findings change surgical management. Alternative methods for screening for common GI conditions should be considered in appropriate patients.