Authors:

Mr. Mohammed Al-Rashedy, Mr. Anirban Ghosh, Ms Sylvia Krivan, Mr. Omer Al-Taan, Mr Aruna Munasinghe

DOI: https://doi.org/10.52338/wjsurgy.2022.1015

Abstract:

Background:
Following bariatric surgery, patients can develop foregut symptoms like dysphagia, reflux, or pain due to stomal ulceration. Oesophagogastroduodenoscopy (OGD) is a diagnostic modality of choice to evaluate these symptoms on most occasions. The objective of this study was to assess the indications and predictors of performing an OGD after bariatric surgery and the treatment offered.
Method:
Patients who had an OGD after a bariatric procedure over one year period were identified, followed up for two years and the indications, findings and treatment offered were studied. A regression model was used to evaluate the predictors of post-operative OGD.
Results:
488 patients underwent bariatric surgery during the 12-month study period. 278 patients had Roux en-Y Gastric Bypass (RYGB) and 202 had Sleeve Gastrectomy (SG). In total, 52 had a postoperative OGD (10.8%). 26 (9.4%) were following RYGB and the other 26 (12.8%) were after SG. Indications for postoperative OGD were dysphagia (44.2%), nausea/vomiting (32%), acid Reflux (19.5%), upper abdominal pain (15.3%) and odynophagia (13%). 22 (42.3%) OGDs were normal, 11 (21%) showed reflux oesophagitis, 7 (13.5%) showed gastritis, 8 (15.3%) showed a small hiatus hernia and 2 (3.8%) patients had a stricture. 47 (90%) were managed medically and two underwent balloon dilatation. No complications were recorded after any of the OGD procedures.
Conclusion:
Post-operative OGD�s took place in around 11% of patients undergoing primary bariatric surgery. There were no specific predictors of which patients required endoscopy, and the majority had normal findings. This study does not support routine OGD following bariatric surgery. However, future studies in both symptomatic and asymptomatic patients over a longer follow up period would allow us a deeper understanding of
the need for routine long-term surveillance of patients following metabolic surgery
Keywords:
Bariatric Surgery, Upper GI Endoscopy, Gastric bypass, Sleeve gastrectomy, Reflux, Abdominal pain.

Citation:

Mohammed Al-Rashedy. Indicators And Predictors Of Postoperative Oesophagogastroduodenoscopy After Bariatric Surgery � Analysis From A Tertiary Bariatric Centre. World Journal of Clinical Surgery 2021.