title: The Role of Routine Upper Gastrointestinal Endoscopy Before Bariatric Surgery.
abstract: Obesity remains a major health concern for which surgery has proven to be the most effective treatment in the long term. Routine upper gastrointestinal endoscopy (UGE) is recommended before surgery, but few studies have evaluated its impact on postoperative complications.
  
  
  
  We studied a cohort of 613 patients submitted to UGE before being listed for bariatric surgery between May 2004 and May 2015. A logistic regression analysis was performed to evaluate potential predictors of postoperative complications.
  
  
  
  Three hundred forty-five patients (56.3 %) presented abnormal endoscopic findings. Helicobacter pylori (Hp) was the strongest predictor of an abnormal endoscopy (OR 10.343, 95 % CI [3.970-26.943], p < 0.001). Of the 342 patients who underwent surgery, 43 (12.6%) developed a postsurgical complication and 2 (0.6%) patients died. In regression analysis, endoscopic ulceration was the only predictor of postoperative complications (OR 11.10, 95 % CI [1.80-68.467], p = 0.01). All patients with gastroduodenal ulcers were infected with Hp.
  
  
  
  UGE before bariatric surgery can identify a wide range of abnormal findings. Gastric and duodenal ulcers appear to be the major findings associated with postoperative complications. Routine Hp eradication may potentially reduce the risk of postoperative complications and should be attempted in all patients before surgery.
authors.affiliation: Serviço de Gastrenterologia e Hepatologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Avenida Professor Egas Moniz, Lisbon, 1649-035, Portugal. Samuelrmfernandes@gmail.com.
authors.forename: Samuel R
authors.initials: SR
authors.lastname: Fernandes
authors.affiliation: Serviço de Gastrenterologia e Hepatologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Avenida Professor Egas Moniz, Lisbon, 1649-035, Portugal.
authors.forename: Liliane C
authors.initials: LC
authors.lastname: Meireles
authors.affiliation: Serviço de Gastrenterologia e Hepatologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Avenida Professor Egas Moniz, Lisbon, 1649-035, Portugal.
authors.forename: Luís
authors.initials: L
authors.lastname: Carrilho-Ribeiro
authors.affiliation: Serviço de Gastrenterologia e Hepatologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Avenida Professor Egas Moniz, Lisbon, 1649-035, Portugal.
authors.forename: José
authors.initials: J
authors.lastname: Velosa
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D015331:Cohort Studies; D005260:Female; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000150:complications / Q000000981:diagnostic imaging*; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D011300:Preoperative Care; D016896:Treatment Outcome; D019564:Unnecessary Procedures
keywords: Bariatric surgery; Helicobacter pylori; Obesity; Upper gastrointestinal endoscopy