Document Detail

Preoperative endoscopic screening for laparoscopic Roux-en-Y gastric bypass has a low yield for anatomic findings.
MedLine Citation:
PMID:  18574642     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Patients undergoing laparoscopic Roux-en-Y bariatric surgery undergo screening esophagoduodenoscopy (EGD) during preoperative evaluation. The hypothesis is to examine the utility of this examination. The purpose of this study was to evaluate the prevalence of clinically significant upper gastrointestinal (UGI) tract findings at screening EGD in patients undergoing laparoscopic Roux-en-Y bariatric surgery. A secondary aim was to determine whether preprocedure symptoms could predict findings at EGD. METHODS: We evaluated records of patients undergoing EGD prior to bariatric surgery between 2000 and 2005 at the Stanford University Medical Center. Clinical, endoscopic, and pathological data were analyzed. The prevalence of endoscopic findings of clinical significance was determined. RESULTS: Two hundred seventy two complete patient records were identified and included in the study. Of these, 237 (87%) were female and 197 (72%) were Caucasian. The mean age was 43 +/- 9.68 years and mean body mass index was 48 +/- 7.95 kg/m(2). Of the 272 patients, 33 (12%) had EGD findings of clinical significance including erosive esophagitis (3.7%), Barrett's esophagus (3.7%), gastric ulcers (2.9%), erosive gastritis (1.8%), duodenal ulcers (0.7%), and gastric carcinoid (0.3%). No patients had malignancy. Of these 33 patients, 22 (67%) had UGI symptoms. CONCLUSIONS: Significant findings at screening EGD were found in 12% of patients. While EGD may be low-yield, the findings could be useful in guiding clinical decision making.
Cindy Mong; Jacques Van Dam; John Morton; Lauren Gerson; Myriam Curet; Subhas Banerjee
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-06-24
Journal Detail:
Title:  Obesity surgery     Volume:  18     ISSN:  0960-8923     ISO Abbreviation:  Obes Surg     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-12     Completed Date:  2009-01-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9106714     Medline TA:  Obes Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1067-73     Citation Subset:  IM    
Department of Medicine, Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA.
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MeSH Terms
Cohort Studies
Endoscopy, Digestive System*
Gastric Bypass*
Middle Aged
Obesity, Morbid / complications,  pathology*,  surgery*
Predictive Value of Tests
Preoperative Care
Retrospective Studies

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