Preoperative esophagogastroduodenoscopy findings and effects on laparoscopic Roux-en-Y gastric bypass in area with high prevalence of Helicobacter pylori infection: multi-center experience in Iran

• Published in: Gastroenterology and hepatology from bed to bench Vol. 15; no. 1; pp. 53 - 58
• Main Authors: Alimadadi, Mehdi, Seyedmajidi, Seyedali, Safamanesh, Sina, Zanganeh, Elena, Hosseini, Seyed Ashkan, Hajiebrahimi, Shahin, Seyyedmajidi, Mohammadreza
• Format: Journal Article
• Language: English
• Published: Iran Shaheed Beheshti University of Medical Sciences 2022
• Subjects: Original; Helicobacter pylori; Esophagogastroduodenoscopy; Gastric bypass surgery
• ISSN: 2008-2258; 2008-4234

The current study aimed to evaluate EGD findings effects on laparoscopic Roux-en-Y gastric bypass (RYGB) plan and time in areas with a high prevalence of infection. Esophagogastroduodenoscopy (EGD) and testing are routine parts of preoperative assessment of bariatric surgery at many centers. This was a crosssectional study of all patients underwent EGD and histopathological examination before laparoscopic RYGB in three gastroenterology centers in Iran between January 2018 and December 2020. In total, 637 patients (52.4% female) were enrolled, of which 46.8% had no abnormal mucosal appearance. In 1.7%, surgery was canceled (gastric adenocarcinoma, gastric intestinal metaplasia, GIST, and esophageal varices). The prevalence of was 61.5%, and there was no statistical difference between groups of normal and abnormal EGD; however, surgery was postponed after eradication in both groups. Overall, 44.4% of patients with esophagitis (any grade), peptic ulcer disease, erosive and non-erosive gastritis/duodenitis, and short segment Barret's esophagus needed medical management. Small- or medium-sized sliding hiatal hernias were seen in 18.7% of patients with no effect on surgery. Moreover, 88.8% of patients with normal mucosal appearance were asymptomatic, but 92.6% in the group with abnormal EGD were symptomatic ( =0.01). Changes in surgical plan and time occurred in 63.6%, but after eliminating eradication, it was 15.4%. Considering gastric cancer and the high prevalence of in Iran, using EGD and histopathological examination as an investigation in the preoperative assessment would have a significant impact on patients undergoing RYGB surgery.