Upper Digestive Endoscopy Prior to Bariatric Surgery in Morbidly Obese Patients - A Retrospective Analysis

Obesity has become one of the world’s major health issues due to its endemic progression and associated comorbidities. The International Association for the Study of Obesity reported that approximately 40-50% of men and 25-35% of women in the EU were overweight (defined as a BMI between 25.0 and 29.9 kg/m2), and an additional 15-25% of men and 15-25% of women were obese (BMI ≥ 30.0 kg/m2) [1]. Obesity is strongly associated with hypertension, type 2 diabetes or insulin resistance, dyslipidemia, coronary heart disease, nonalcoholic fatty liver disease (ranging from simple steatosis to steatohepatitis, hepatic cirrhosis and end-stage liver disease), hepatocellular carcinoma and multiple other types of cancer, including colonic and gynecological cancers. This is why the treatment of obesity has become one of the major concerns of health systems in the affected areas, including primarily economically developed countries. To date, bariatric surgery is the only treatment that has shown long-term usefulnes. Despite the existing guidelines for the preoperative evaluation of the morbidly obese patients candidates for bariatric surgery, the routine preoperative upper GI endoscopy is still a matter of debate. By analyzing the impact of endoscopic findings on the bariatric surgical management, some authors found that routine preoperative upper endoscopy is not required [2]; however, a study on 212 morbidly obese patients who underwent bariatric procedures showed a high prevalence of gastrointestinal diseases with a significant impact on perioperative management in two thirds of the cases of bariatric patients who underwent preoperative upper GI endoscopy and therefore they recommend routine gastroscopy about 2-4 weeks prior to surgery [3]. Material and Methods