Wilson MSJ, Alhamdani A, Mahawar K, Boyle M

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Postoperative upper gastrointestinal endoscopies in gastric bypass patients: Frequency and findings Wilson MSJ, Alhamdani A, Mahawar K, Boyle M*, Schroeder N, Balupuri S, Small PK Department of General Surgery and Dietetics*, Sunderland Royal Hospital

BACKGROUND A number of patients require postoperative endoscopies after laparoscopic roux-en-y gastric bypass (LRYGB). The most common indication for endoscopy is for dyspepsia. This study reports the frequency of such examinations, and the nature of the findings at endoscopy. Between January 2005 and August 2010 we have performed 309 LRYGB.

METHODS Patients who had undergone LRYGB were identified from our prospectively maintained database. Those requiring postoperative endoscopy were identified by cross referencing with the hospital information support system (HISS) and endoscopy database. Endoscopic findings were then documented and classified using a proforma.

RESULTS Up to August 2010, 53 (17.2%) patients had required 85 upper gastrointestinal endoscopies in the postoperative period. The mean age of patients was 43.4 years (range 18-66). 246 (79.6%) patients were females with a mean follow-up of 17.9 months.

RESULTS No. endoscopies No. patients 1 34 (64%) 2 12 (22%) 3 4 (8%) 4 1 (2%) 5 2 (4%)

RESULTS Frequency of findings

DISCUSSION 17% of our LRYGB patients have undergone endoscopy in the postoperative period. Of these , 64% underwent one endoscopy, with 36% requiring more than one endoscopy. In 47% of patients, no abnormality was detected. In 45% of patients, endoscopic findings were attributable to their LRYGB.

CONCLUSION A significant proportion of patients undergoing LRYGB require upper gastrointestinal endoscopy in the postoperative period for various indications. Surgeons should be aware of the above endoscopic findings in the early and late post operative period after LRYGB, and of the need to perform early endoscopy in patients reporting dyspeptic symptoms. This area requires further study.