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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 Publisher



Alimadadi M1 ; Seyedmajidi S2 ; Safamanesh S3 ; Zanganeh E1 ; Hosseini SA4 ; Hajiebrahimi S1 ; Seyyedmajidi M1
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Authors Affiliations
  1. 1. Golestan Research Center of Gastroenterology and Hepatology (GRCGH), Golestan University of Medical Sciences, Gorgan, Iran
  2. 2. Dental Materials Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
  3. 3. Minimally Invasive Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Mashhad University of Medical Sciences, Mashhad, Iran

Source: Gastroenterology and Hepatology from Bed to Bench Published:2022


Abstract

Aim: 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 Helicobacter pylori infection. Background: Esophagogastroduodenoscopy (EGD) and Helicobacter pylori testing are routine parts of preoperative assessment of bariatric surgery at many centers Methods: This was a cross-sectional study of all patients underwent EGD and histopathological examination before laparoscopic RYGB in three gastroenterology centers in Iran between January 2018 and December 2020. Results 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 H. pylori was 61.5%, and there was no statistical difference between groups of normal and abnormal EGD; however, surgery was postponed after H. pylori 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 (p=0.01). Changes in surgical plan and time occurred in 63.6%, but after eliminating H. pylori eradication, it was 15.4%. Conclusion: Considering gastric cancer and the high prevalence of H. pylori in Iran, using EGD and histopathological examination as an investigation in the preoperative assessment would have a significant impact on patients undergoing RYGB surgery. © 2022 RIGLD.
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