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The role of upper gastrointestinal endoscopy in bariatric procedure selection: A case series and literature review

1 Centre for Metabolic Surgery, Wockhardt Hospital, Mumbai, Maharashtra, India
2 Department of Gastroenterology, Wockhardt Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Aashik Shetty,
Centre for Metabolic Surgery, Wockhardt Hospital, 1877, Doctor Anand Rao Nair Marg, Near Agripada Police Station, Mumbai Central East, Mumbai - 400 011, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmas.JMAS_139_19

Background: Bariatric surgery leads to a significant improvement in obesity and associated comorbidities. Safe surgical outcomes are especially desirable in bariatric, as most patients perceive it as an aesthetic surgery, while an intestinal/gastric surgery may be associated with morbidity. A detailed pre-operative evaluation is required to avoid surgical surprises and post-operative complications. Besides other routine investigations, pre-surgery upper gastrointestinal (GI) endoscopy has always been a topic of debate. Some surgeons perform it routinely before the surgery, whereas others perform it selectively. It is mostly accepted that pre-operative diagnosis of gastro-oesophageal reflux disease could change the plan of surgery in favour of Roux-en-Y gastric bypass although similar consensus does not exist in favour of Sleeve gastrectomy if a gastric/duodenal pathology is detected pre-operatively in a planned roux-en-y gastric bypass patient. Aim: Through this case series, we want to highlight the role of routine pre-operative upper GI endoscopy in selecting the bariatric surgery. Cases: We present four cases, from amongst many others, where endoscopy changed the course of bariatric surgery. Conclusion: Upper GI endoscopy should be performed before bariatric surgery, even in asymptomatic patients, to avoid post-operative surprise/complication.

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2004 Journal of Minimal Access Surgery
Published by Wolters Kluwer - Medknow
Online since 15th August '04