Introduction: Postoperative upper digestive endoscopy seems to give conflicting results in literature after obesity surgery. Some stressed on the frequency of major digestive lesions such as esophagitis, cancer or endo brachy esophagus (EBO) especially after Sleeve Gastrectomy (SG). The incidence of EBO after SG was found in 1.2% to 15% at ten years of follow up. Accordingly to European Guidelines, it is mandatory to perform a routinely preoperative gastroscopy but not after surgery.
Methods: We conducted a prospective study. We mailed a prescription of gastroscopy by mail at each patient who had a bariatric surgery from April 1, 2010 to August 31, 2014. We collected results during their annual follow-up (January 2018), but also by mail or e-mail.
Results: 57 out of 578 patients gave us the results of gastroscopy. The mean age was 51±9.2 years, 92% were women, the average BMI before intervention was 44.14±5.01 kg/m2 and 48 had longitudinal sleeve gastrectomy, 9 had a revisional bariatric operation. The mean BMI loss was 14.24 kg/m2 and the average follow-up 5 years. Only 28% presented gastroesophageal symptoms. The endoscopic results of these 57 patients were 17 normal, 21 gastritis, 10 oesophagitis, 13 hiatal hernia and 8 HP infections. There was no cancer and one EBO de novo with incomplete intestinal metaplasia. All patients with esophagitis underwent SG.
Conclusions: In our study the frequency of endoscopic abnormalities at mean follow-up of 5 years suggest the necessity of a systematic endoscopic follow-up, especially in asymptomatic patients. Strong recommendations about upper digestive endoscopic surveillance after bariatric surgery are needed especially in SG.
18 - 21 May 2019
European Society of Endocrinology