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

World Journal of Gastrointestinal Endoscopy 2016年第10期8卷 409-417页

作者： Mohamed E Abd Ellatif Haitham Alfalah Walid A Asker Ayman E El Nakeeb Alaa magdy Waleed Thabet Mohamed A Ghaith Emad Abdallah Rania Shahin Asharf Shoma Ibraheim E Dawoud Ashraf Abbas Asaad F Salama Maged ali Gamal Department of Surgery Mansoura University Hospital Consultant of Bariatric Surgery King Saud Medial City (KSMS) Gastroenterology Surgical Center Mansoura University Department of Anesthesia Mansoura University Hospital Department of Clinical Pathology Benha University Hospital Department of Surgery Jahra Hospital

AIM: To study the preoperative and postoperative role of upper esophagogastroduodenoscopy(EGD) in morbidly obese patients. METHODS: This is a multicenter retrospective study by reviewing the database of patients who underwent bariatric surgery(laparoscopic sleeve gastrectomy, laparoscopic Roux en Y gastric bypass, or laparoscopic minigastric bypass) in the period between 2001 June and 2015 August(Jahra Hospital-Kuwait, Hafr Elbatin Hospital and King Saud Medical City-KSA, and Mansoura University Hospital- Egypt). Patients with age 18-65 years, body mass index(BMI) > 40, or > 35 with comorbidities after failure of many dietetic regimen and acceptable levels of surgical risk were included in the study after having an informed signed consent. We retrospectively reviewed the medical charts of all morbidly obese patients. The patients' preoperative data included clinical history including upper digestive symptoms and preoperative full workup including EGD. Only patients whose charts revealed weather they were symptomatic or not were studied. We categorized patients accordingly into two groups; with(group A) or without(group B) upper digestive symptoms. The endoscopic findings were categorized into 4 groups based on predetermined criteria. The medical record of patients who developed stricture, leak or bleeding after bariatric surgery was reviewed. Logestic regression analysis was used to identify preoperative predictors that might be associated with abnormal endoscopic findings. RESULTS: Three thousand, two hundred and nineteen patients in the study period underwent bariatric surgery(75% LSG, 10% LRYDB, and 15% MGB). Mean BMI was 43 ± 13, mean age 37 ± 9 years, 79% were female. Twenty eight percent had presented with upper digestive symptoms(group A). EGD was considered normal in 2414(75%) patients(9% group A vs 66% group B, P = 0.001). The abnormal endoscopic findings were found high in those patients with upper digestive symptoms. Abnormal findings(one or more) were fo

关键词： Morbid obesity Obesity surgery Endoscopy Complications Dilation Stenting

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