title: Current Status of Preoperative Oesophago-Gastro-Duodenoscopy (OGD) in Bariatric NHS Units-a BOMSS Survey.
abstract: Preoperative oesophago-gastro-duodenoscopy (p-OGD) is often routinely employed in patients undergoing bariatric surgery. The value of p-OGD is still unclear; however, since all bariatric procedures modify stomach anatomy differently with exclusion of the remnant in a majority of cases, the question arises whether there is a rational for including it routinely in the preoperative pathway.
  
  
  
  To assess the current status of p-OGD in the UK, a survey was sent to the British Obesity & Metabolic Surgery Society members, regarding preoperative evaluation of patients, focusing on the role of p-OGD. Forty-nine UK bariatric units (in excess of 5000 patients estimated caseload/year) answered.
  
  
  
  The survey has shown that 44 units (90 %) include OGD in their preoperative work up, routinely or selectively. According to results, 25 units (51 %) changed the operative plans after OGD because of peptic ulcer (46 %), hiatus hernia (43 %), Barrett's oesophagus (32 %) or gastrointestinal stromal tumour (25 %). Only 2 units (7 %) found incidental gastrointestinal cancer. When specifically asked, p-OGD was believed to be essential in patients with family history of gastrointestinal cancer (61 %), pernicious anaemia (57 %) and reflux symptoms (54 %). Five units (10 %) considered p-OGD completely unnecessary. Only 11 units (25 %) would not be able to accommodate routine p-OGD in all patients.
  
  
  
  Most units value p-OGD, either selectively or routinely, in preparation for bariatric surgery. However, there seems to be a discrepancy on the specific risk factors involved in the selection process. National and international guidelines are advocated.
authors.affiliation: Gastrointestinal Services, General Surgery, University College Hospital, 235 Euston Road, London, NW1 2BU, UK. dani83k@gmail.com.
authors.forename: Daniela
authors.initials: D
authors.lastname: Zanotti
authors.affiliation: Gastrointestinal Services, General Surgery, University College Hospital, 235 Euston Road, London, NW1 2BU, UK.|Medical Research Institute, University of Alexandria, Alexandria, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Elkalaawy
authors.affiliation: Gastrointestinal Services, General Surgery, University College Hospital, 235 Euston Road, London, NW1 2BU, UK.
authors.forename: Majid
authors.initials: M
authors.lastname: Hashemi
authors.affiliation: Gastrointestinal Services, General Surgery, University College Hospital, 235 Euston Road, London, NW1 2BU, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Jenkinson
authors.affiliation: Gastrointestinal Services, General Surgery, University College Hospital, 235 Euston Road, London, NW1 2BU, UK.
authors.forename: Marco
authors.initials: M
authors.lastname: Adamo
mesh_terms: D050110:Bariatric Surgery / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004384:Duodenoscopy / Q000009:adverse effects / Q000706:statistics & numerical data; D006801:Humans; D009767:Obesity, Morbid / Q000601:surgery; D011300:Preoperative Care / Q000009:adverse effects / Q000706:statistics & numerical data; D006113:United Kingdom / Q000453:epidemiology
keywords: Bariatric surgery; Obesity; Preoperative OGD; Preoperative work up; Upper gastrointestinal endoscopy