Clinical Relevance of Preoperative Upper Gastrointestinal Endoscopy before Sleeve Gastrectomy: A Retrospective Cohort Study of 30-Day Outcomes.

Authors

Hasan Eroğlu, Ahmed Taha, İskender Eren Demirbaş, Özgür İbiş

Published in

Journal of laparoendoscopic & advanced surgical techniques. Part A. Pages 10926429261486299. Sep 07, 2026. Epub Sep 07, 2026.

Abstract

Routine preoperative upper gastrointestinal endoscopy before sleeve gastrectomy remains debated. This study evaluated whether selected endoscopic and histopathologic findings were associated with 30-day outcomes after sleeve gastrectomy, with specific attention to reflux-related events and severity-stratified staple-line leak.
We retrospectively analyzed 315 adults who underwent laparoscopic sleeve gastrectomy at a tertiary referral center between June 2016 and December 2019. All patients underwent preoperative esophagogastroduodenoscopy with Sydney-protocol biopsies. Postoperative outcomes were assessed within 30 days. The leak was classified as limited/minimal when managed with antibiotics alone and as major when invasive intervention or death occurred.
Postoperative reflux symptoms occurred in 47 patients (14.9%). Staple-line leak was diagnosed in 13 patients (4.1%) after oral intake using clinical findings, inflammatory markers, and contrast-enhanced computed tomography; routine postoperative day 1 upper gastrointestinal contrast passage studies were normal in all leak patients. Ten leaks were limited/minimal and resolved with antibiotics alone, whereas 3 patients (0.95%) had major leaks requiring percutaneous/endoscopic or surgical intervention. Hiatal hernia was associated with postoperative reflux symptoms, and previous upper abdominal surgery was associated with leak. Associations involving endoscopic bile reflux/possible pyloric dysfunction were exploratory because objective motility testing was unavailable.
Preoperative endoscopy may identify selected foregut abnormalities relevant to early outcomes after sleeve gastrectomy, particularly reflux-related anatomy. Leak-related findings should be interpreted cautiously because event numbers were small; severity-stratified reporting provides a more clinically meaningful interpretation than an undifferentiated leak rate.

PMID:
42704683
Bibliographic data and abstract were imported from PubMed on 08 Sep 2026.

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