Preoperative Endoscopy Prior to Bariatric Surgery: a Systematic Review and Meta-Analysis of the Literature
Abstract
Background There is debate regarding preoperative endoscopy (EGD) in patients undergoing bariatric surgery. Some centers perform EGD routinely in all patients; others perform EGD selectively. The objective of this study was to perform a systematic review and meta-analysis of the existing literature to estimate how frequently preoperative EGD changes management.Methods Our review yielded 28 studies encompassing 6616 patients. Baseline characteristics including age and body mass index (BMI) were included. Patients were grouped based on EGD findings into two groups: Group 1-findings which did not significantly change management (e.g., mild/moderate duodenitis, Grade A/B esophagitis, mild/moderate gastritis, H. pylori infection, hiatal hernia <2 cm); Group 2-findings which delayed, altered, or cancelled surgery (e.g., severe duodenitis, Grade C/D esophagitis, gastric varices, hiatal hernia >2 cm, mass/carcinoma). A general estimating equation (GEE) model accounting for the correlated data within each study was used to calculate confidence intervals around the estimate of how frequently surgery was delayed or altered.Results Mean age was 41.4 ± 2.9 years, the majority was women, and mean preoperative BMI was 47 ± 3.2 kg/m 2. Overall 92.4 % (n = 6112) had a normal EGD or findings that did not change clinical management and 7.6 % (n = 504); 95 % CI [4.6, 12.4 %] had findings that delayed/altered surgery. The revised estimate was 20.6 %; 95%CI [14.5, 28.2 %] if all esophagitis (regardless of grade) were categorized into Group 2. The approximate incidence of Barrett's esophagus and carcinoma were 0.1 and 0.08 %, respectively.Conclusion A selective approach to preoperative EGD may be considered, based on the patients' symptoms, risk factors, and type of procedure planned.
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Two systematic reviews were available on preoperative endoscopy.
“Two systematic reviews were available on this topic [7, 8, 41, 42]”
The second meta-analysis demonstrated similar findings on preoperative endoscopy.
“The second meta-analysis demonstrated similar findings [42].”
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Mathus-Vliegen, E. M. H., & Dargent, J. (2018) · Springer eBooks · doi:10.1007/978-3-319-90074-2_4
Kroh, M. (2020) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2020.05.001
Is Routine Upper Endoscopy and H. pylori Testing Indicated in Advance of Bariatric Surgery?
Odenwald, M. A., & Kavitt, R. T. (2020) · Difficult decisions in surgery: an evidence-based approach · doi:10.1007/978-3-030-55329-6_14
Scott, J. D. (2021) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2021.01.017
Morin, N. P., Lim, D., Jaikaran, O., Skowronek, A., & Muthusamy, M. (2021) · Bariatric Surgical Practice and Patient Care · doi:10.1089/bari.2020.0029
Galloro, G., Musella, M., Siciliano, S., Berardi, G., Vitiello, A., Velotti, N., Rizzello, F., Gionchetti, P., & Calabrese, C. (2022) · Endoscopy International Open · doi:10.1055/a-1723-3109
Preoperative Assessment of Patients Undergoing Bariatric Sleeve Gastrectomy: A Cross-Sectional Study
Tawfik, M., Aldawas, N. F., Almegbil, N., Hamad, A. A. B., Alanazi, A., Alaidaroos, A., Al-Rawaf, T., & Fayed, A. A. (2022) · Gastroenterology Research and Practice · doi:10.1155/2022/3622119
Silva, J. P., & Lipham, J. C. (2022) · Foregut Surgery · doi:10.51666/fs.2022.2.e6
Endoscopia digestiva em pré-operatório de cirurgia bariátrica: é necessária?
de Brito, N. P., Lessa, M. H. D. M., Pereira, I. R. R., Pereira, L. M., Filho, W. S. O., Pulgatti, M. B., da Silva, G. I., Dantas, G. G. B., Albuquerque, M. P. A., & Leite, C. Q. (2022) · Revista Eletrônica Acervo Saúde · doi:10.25248/reas.e11210.2022
Cáncer gástrico y cirugía bariátrica: a propósito de un caso
Vallejo, D., Tapia, M. O., & Vidal, G. T. (2022) · Revista de Cirugía · doi:10.35687/s2452-454920220061585
Endoscopic Anatomy of the Bariatric Patient
Youssef, M. R., Farhoud, A. S., Freeman, M. N., Moore, R., & Galvani, C. A. (2023) · Springer eBooks · doi:10.1007/978-3-031-21044-0_35
Surgery for Obesity and Its Consequences
Borg, C.-M., & Deguara, J. (2023) · Springer eBooks · doi:10.1007/978-3-031-22265-8_20
Endoscopic Evaluation of the Bariatric Surgery Patient
Djouzi, S. E. (2023) · Springer eBooks · doi:10.1007/978-3-031-39199-6_16
Iossa, A., Micalizzi, A., Cavallaro, G., Giuffrè, M., Palma, F., Angelis, F. D., & Silecchia, G. (2024) · Bariatric Surgical Practice and Patient Care · doi:10.1089/bari.2024.0012
How to Create a Comprehensive Bariatric Center
Clapp, M. D. B., & Pesta, D. O. C. (2024) · Springer eBooks · doi:10.1007/978-3-031-72309-4_9
Lim, J., Kim, A. G., Vidmar, A. P., Vu, M. H., Samakar, K., Martin, M. J., Abel, S. A., Belteton, G. F., & Wong, H. J. (2026) · Journal of Pediatric Surgery · doi:10.1016/j.jpedsurg.2026.163177
Preoperative Endoscopy in Primary Bariatric Surgery
Grille, V. J., & Rogers, A. M. (2026) · Springer eBooks · doi:10.1007/978-3-032-24278-5_45
Genç, H. Ç. (2026) · Journal of Laparoendoscopic & Advanced Surgical Techniques · doi:10.1177/10926429261468975
Campos, G. M., Tsering, D., & Mazzini, G. S. (2026) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2026.08.014
Abulfaraj, M. W., Aljiffry, M., Alhazmi, M. F., Maghrabi, A. A., Bokhary, R., Alotaibi, A. F. A., Fouad, R., El‐Sherbiny, M., Ebrahim, H. A., Ali, T. S. A. M., et al. (2026) · Medicine · doi:10.1097/md.0000000000051246
- Authors
- Parikh, M., Liu, J., Vieira, D., Tzimas, D., Horwitz, D., Antony, A., Saunders, J. K., Ude-Welcome, A., & Goodman, A.
- Affiliations
- NYU Langone Health (US)
- Corresponding author
- Parikh, Manish
- Venue
- Obesity Surgery
- Published
- 2016-05-20
- Volume
- 26
- Issue
- 12
- Pages
- 2961-2966
- ISSN
- 0960-8923 (ISSN-L)
- 1708-0428
- OpenAlex
- W2401653609
- Cited by
- 85
- References
- 19
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 9 · 2023: 7 · 2022: 14 · 2021: 9 · 2020: 20 · 2019: 8 · 2018: 2 · 2017: 4 · 2016: 1
- FWCI
- 0.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Obesity Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal Bleeding Diagnosis and Treatment
- Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
- Keywords
- preoperative endoscopy, bariatric surgery
- MeSH terms
- Adult, Female, Gastrointestinal Diseases, Humans, Male, Middle Aged, Obesity, Preoperative Care, Endoscopy, Gastrointestinal, Bariatric Surgery
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