title: Preoperative Endoscopy and Its Impact on Perioperative Management in Bariatric Surgery.
abstract: BACKGROUND
  The role of preoperative upper-gastrointestinal endoscopy for bariatric surgery is still understood only with controversy. The aim of this study was to evaluate the prevalence of endoscopic findings and its impact on perioperative management.
  
  
  METHODS
  Patients who underwent bariatric surgery at our center between 2010 and 2013 were systematically analyzed from a prospective database.
  
  
  RESULTS
  Two hundred and twelve patients with a median body mass index of 50 kg/m(2) (range 29-87) underwent 216 bariatric procedures at our center between 2010 and 2013. All patients received preoperative upper endoscopy. In 159 cases (75%), the endoscopy was performed at our center. These cases were included in this study. In 37 cases (23%), no abnormal findings were detected. In 122 cases (76%), upper endoscopy revealed pathologies. No further treatment was necessary in 24 cases (15%). Medical treatment was changed in 81 cases (51%). The operation was delayed due to medical treatment and re-endoscopy in 13 cases (8%). The surgical approach was changed in 4 cases (3%).
  
  
  CONCLUSIONS
  Routinely performed preoperative endoscopy before bariatric surgery revealed a high prevalence of gastrointestinal diseases with a significant impact on perioperative management in two thirds of the cases. Therefore, we recommend routine gastroscopy about 2-4 weeks prior to surgery.
authors.affiliation: Department of Visceral-, Transplantation-, Thoracic- and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Wiltberger
authors.forename: Julian Nikolaus
authors.initials: JN
authors.lastname: Bucher
authors.forename: Moritz
authors.initials: M
authors.lastname: Schmelzle
authors.forename: Albrecht
authors.initials: A
authors.lastname: Hoffmeister
authors.forename: Arne
authors.initials: A
authors.lastname: Dietrich
mesh_terms: D000328:Adult; D000368:Aged; D050110:Bariatric Surgery; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005767:Gastrointestinal Diseases / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000601:surgery*; D019990:Perioperative Care; D011300:Preoperative Care / Q000379:methods*; D015995:Prevalence; D012189:Retrospective Studies