Is gastroscopy necessary before bariatric surgery?

Area of Science:

• Bariatric and Metabolic Surgery
• Gastroenterology
• Public Health

Background:

• Obesity is a global pandemic and the second leading cause of preventable death.
• Bariatric surgery is a common treatment for obesity, requiring careful preoperative evaluation.
• The necessity of esophagogastroduodenoscopy (EGD) before bariatric surgery remains a debated topic in the literature.

Purpose of the Study:

• To investigate the necessity of routine esophagogastroduodenoscopy (EGD) prior to bariatric surgery.
• To review current guidelines and expert opinions on preoperative EGD for different bariatric procedures.
• To determine the role of EGD in the preoperative assessment of obese patients undergoing bariatric interventions.

Main Methods:

• Literature review of guidelines from European and American surgical and endoscopic societies.
• Analysis of expert consensus statements regarding preoperative EGD for sleeve gastrectomy and Roux-en-Y gastric bypass.
• Examination of differing recommendations based on patient symptomatology and surgical procedure type.

Main Results:

• European guidelines recommend EGD for all bariatric procedures, especially Roux-en-Y gastric bypass (RYGB).
• Some studies recommend routine preoperative EGD for sleeve gastrectomy, even in asymptomatic patients, while others reserve it for symptomatic RYGB patients.
• The American Society for Gastrointestinal Endoscopy suggests EGD only for symptomatic patients undergoing bariatric surgery.

Conclusions:

• There is a lack of consensus on the routine use of preoperative EGD for all bariatric surgeries.
• Performing EGD before bariatric surgery is considered a form of insurance for patients and physicians.
• Further large-scale prospective studies are needed to establish definitive conclusions on the necessity of preoperative EGD.