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Obes Surg ; 16(2): 142-6, 2006 Feb.
Article in English | MEDLINE | ID: mdl-16469214

ABSTRACT

BACKGROUND: Preoperative evaluation of patients undergoing laparoscopic Roux-en-Y gastric bypass (LRYGBP) has included esophagogastroduodenoscopy (EGD) with little data to substantiate its use. METHODS: A retrospective analysis was conducted of patients from Feb 04 to Mar 05 who underwent preoperative EGD and subsequently LRYGBP. RESULTS: 169 patients underwent EGD prior to surgery. Their mean age was 41.1 years (range 14-66), mean BMI 49.7 (range 35-78), and 82% were females. There were no complications from EGD. Significant findings in patients at EGD included gastric ulceration in 3 (2%), duodenal ulcer in 1 (0.7%), Barrett's esophagus in 2 (1.3%), and a GI stromal tumor (GIST) in 1 (0.7%). EGD revealed hiatal hernias in 56 (35.2%), esophagitis in 28 (17%), Schatzki's ring in 5 (3%), gastritis in 43 (27%), gastric polyps in 8 (5%), and duodenitis in 9 (6%). 53 patients (33.3%) had a negative EGD. Ulcer and severe gastritis, esophagitis, and duodenitis diagnosed preoperatively were treated medically before surgery. 9 hiatal hernias were repaired intraoperatively. The patient with the GIST underwent laparoscopic near-total gastrectomy and gastric bypass, while 1 patient with an antral polyp underwent laparoscopic partial gastrectomy in addition to the LRYGBP. CONCLUSION: EGD is essential for diagnosis of GI diseases including tumors, ulcers, and hiatal hernias that alter the medical and surgical management of patients undergoing gastric bypass.


Subject(s)
Endoscopy, Digestive System/methods , Gastric Bypass/methods , Gastrointestinal Diseases/diagnosis , Laparoscopy/methods , Adolescent , Adult , Aged , Anastomosis, Roux-en-Y/methods , Body Mass Index , Cohort Studies , Digestive System Neoplasms/diagnosis , Digestive System Neoplasms/epidemiology , Female , Follow-Up Studies , Gastrointestinal Diseases/epidemiology , Humans , Incidence , Male , Middle Aged , Obesity, Morbid/diagnosis , Obesity, Morbid/surgery , Preoperative Care/methods , Prospective Studies , Risk Assessment , Sensitivity and Specificity
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