Upper gastrointestinal endoscopy performed before sleeve gastrectomy in patients with morbid obesity: retrospective analysis of 460 patients

Objective: We aim to retrospectively evaluate results of preoperative upper gastrointestinal endoscopy(UGE) performed in our endoscopy unit on morbid obese patients who underwent Laparoscopic Sleeve Gastrectomy (LSG).
Material and Method: The study was carried out on 460 morbid obese patients who underwent UGE before LSG at the General Surgery Endoscopy Unit of Keçiören Training and Research Hospital and their age, body mass index, additional diseases and endoscopy findings were evaluated..From endoscopy findings, antral gastritis, LES laxity, pyloric dysfunction, esophagitis, hiatal hernia, pancreatitis, body mass index were evaluated with univariate analysis and comparative logistic method.
Findings: UGE was performed in 460 patients who were scheduled for LSG. Patients had antral gastritis, 46 (10%) patients had pangastritis, 30 (6.6%) patients had esophagitis, 163 (35.6) patients had LES laxity, 58 (12.7%) patients had Hiatal Hernia, 25 (5.5%) patients had pylor dysfunction and additional comorbidities were detected in 18 (3.9;%) patients.Patients with antral gastritis had statistical significance with LES laxity and age (p 0,002, p 0,003), patients with pancreatitis had statistical significance with Hiatal Hernia, pyloric dysfunction and LES laxity(p 0.007, p 0.004, p 0.002). There is also significant statistical relationship between esophagitis and hiatal hernia (p 0.001).In multivariant analysis; Hiatal Hernia increased the risk of pancreatitis by 2.5 times, while LES laxity increased risk of pangastritis by 0.42 times. Pyloric dysfunction has been shown to increase pangastritis risk by 5.6 fold.Age increased risk of antral gastritis by 1.04 fold, and LES laxity increased risk of antral gastritis by 2.07 fold.
Discussion and Conclusion:
We believe that an upper GIS endoscopy that will be performed before obesity surgery will play a very important role in surgical method selection.