The Yield of Preoperative Esophagogastroduodenoscopy in Patients Undergoing Bariatric Surgery After Gastric Banding

Background and Aims

Esophagogastroduodenoscopy (EGD) is routinely performed in patients who undergo conversion from adjustable gastric banding to another bariatric procedure (eg, gastric bypass) of band removal. Band erosion is the main concern in these patients. The objective of this study was to analyze the yield of EGD in these patients.

Methods

All patients between 2008 and 2020 who underwent bariatric surgery with an adjustable gastric band in place were included. Results of EGD were analyzed retrospectively and categorized according to clinical consequences.

Results

Overall, 514 patients (62 male, 452 female; mean age 46 years; mean BMI 40) underwent surgery with an adjustable gastric band in situ. In total, 488 patients (95%) underwent preoperative EGD. No abnormalities were found in 205 patients (42%), 112 patients (23%) had abnormalities without treatment consequences, 156 patients (32%) had findings that required pharmaceutical (ie, proton pump inhibitors and/or antibiotics) intervention, and 15 patients (3.1%) had severe findings altering management (group D). In 5 of these patients (1.0%), surgery was postponed due to Barrett's esophagus, and 10 of these patients (2.0%) had gastric band erosion. No subgroup of patients could be identified to increase the yield of the EGD.

Conclusion

Routine preoperative assessment by EGD in patients before bariatric surgery with an adjustable gastric band in situ still detects some severe abnormalities significantly altering management.