Shetty Aashik, Nasta Amrit, Gupte Amit, Goel Ramen
Centre for Metabolic Surgery, Wockhardt Hospital, Mumbai, Maharashtra, India.
Department of Gastroenterology, Wockhardt Hospital, Mumbai, Maharashtra, India.
J Minim Access Surg. 2021 Jan-Mar;17(1):81-84. doi: 10.4103/jmas.JMAS_139_19.
Bariatric surgery leads to a significant improvement in obesity and associated comorbidities. Safe surgical outcomes are especially desirable in bariatric, as most patients perceive it as an aesthetic surgery, while an intestinal/gastric surgery may be associated with morbidity. A detailed pre-operative evaluation is required to avoid surgical surprises and post-operative complications. Besides other routine investigations, pre-surgery upper gastrointestinal (GI) endoscopy has always been a topic of debate. Some surgeons perform it routinely before the surgery, whereas others perform it selectively. It is mostly accepted that pre-operative diagnosis of gastro-oesophageal reflux disease could change the plan of surgery in favour of Roux-en-Y gastric bypass although similar consensus does not exist in favour of Sleeve gastrectomy if a gastric/duodenal pathology is detected pre-operatively in a planned roux-en-y gastric bypass patient.
Through this case series, we want to highlight the role of routine pre-operative upper GI endoscopy in selecting the bariatric surgery.
We present four cases, from amongst many others, where endoscopy changed the course of bariatric surgery.
Upper GI endoscopy should be performed before bariatric surgery, even in asymptomatic patients, to avoid post-operative surprise/complication.
减肥手术可显著改善肥胖及相关合并症。在减肥手术中，安全的手术结果尤为重要，因为大多数患者将其视为美容手术，而肠道/胃部手术可能会伴有发病风险。需要进行详细的术前评估以避免手术意外和术后并发症。除其他常规检查外，术前上消化道（GI）内镜检查一直是一个有争议的话题。一些外科医生在手术前常规进行此项检查，而另一些医生则选择性地进行。人们大多认为，术前诊断胃食管反流病可能会改变手术方案，转而采用 Roux-en-Y 胃旁路手术，不过，如果在计划进行 Roux-en-Y 胃旁路手术的患者术前检测到胃/十二指肠病变，对于是否因此改变为袖状胃切除术，目前尚无类似的共识。
通过这个病例系列，我们想强调术前常规上消化道内镜检查在选择减肥手术中的作用。
我们呈现了四个病例（众多病例中的一部分），内镜检查改变了减肥手术的进程。
即使是无症状患者，减肥手术前也应进行上消化道内镜检查，以避免术后意外/并发症。
