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Routine Preoperative Oesophagogastroduodenoscopy Before Roux‐En‐Y Gastric Bypass: A Retrospective Cohort Analysis From Queensland, Australia

Year: 2026

Type: article

Abstract: INTRODUCTION: The role of routine preoperative oesophagogastroduodenoscopy (POOGD) with routine biopsies prior to Roux-en-Y gastric bypass (RYGB) remains controversial. Whether POOGD should be routinely offered or reserved for symptomatic and/or at-risk patients is heavily debated. This study aimed to determine the proportion of patients undergoing RYGB in whom POOGD altered surgical management. METHODS: A retrospective review of medical records from 2016 to 2024 was performed using data from Surgery Brisbane, Queensland, Australia. Demographic data, clinical characteristics, POOGD findings, and operative outcomes were collected. POOGD findings were categorised as benign (e.g., oesophagitis, gastritis, duodenitis, peptic ulcer disease [PUD], hiatus hernia [HH]) or premalignant (e.g., intestinal metaplasia [IM], Barrett's oesophagus [BO] and Helicobacter pylori infection [HP]). RESULTS: (88.2%). POOGD identified abnormalities in 338 patients (80.0%), including benign findings in 235 (55.6%) and premalignant findings in 103 (24.3%). The most common benign findings were oesophagitis (184, 43.5%) and gastritis (175, 41.4%). IM was identified in 54 patients (12.8%), including three (0.7%) with corpus involvement. Amongst patients with premalignant findings, 32 (31.1%) were asymptomatic. POOGD findings altered surgical management in 18 patients (4.2%): 14 (3.3%) underwent RYGB plus resection of the remnant stomach (RRS), two (0.5%) experienced a delay due to untreated PUD, and two (0.5%) were offered an alternative bariatric procedure. Four hundred and five patients (95.7%) proceeded with RYGB as planned. CONCLUSION: RYGB alters gastric anatomy, rendering the remnant stomach inaccessible postoperatively. Preoperative detection of premalignant lesions may be uncommon but clinically valuable, particularly given that such findings can be asymptomatic and may represent precursors to gastric adenocarcinoma. Considering its safety, diagnostic value, and potential to alter surgical management, the findings of this study support the routine use of POOGD with routine biopsies prior to RYGB.

Source: ANZ Journal of Surgery

DOI: 10.1111/ans.70927

Authors: Shahab Valizadehzare, Michael Hatzifotis

Institutions: The University of Queensland, Greenslopes Private Hospital, Princess Alexandra Hospital

Language: English

Topic: Bariatric Surgery and Outcomes

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,920