The utility of esophagogastroduodenoscopy and Helicobacter pylori screening in the preoperative assessment of patients undergoing bariatric surgery: A cross-sectional, single-center study in Saudi Arabia

AlEid, Ahmad; Balkhi, Areej Al; Hummedi, Ali; Alshaya, Anfal; Abukhater, Muhammad; Mtawa, Abdullah Al; Khathlan, Abdullah Al; Qutub, Adel; Sayari, Khalid Al; Ahmad, Shameem; Azhar, Tauseef; Otaibi, Nawaf Al; Ghamdi, Ahmed Al; Lehibi, Abed Al

doi:10.4103/sjg.sjg_165_19

Cited by 7 publications

(6 citation statements)

References 19 publications

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“…The majority of the H. pylori -infected patients were in the age group 22-44 years old (67.9%). Another study by Aleid et al [ 20 ] demonstrated that the prevalence of H. pylori in patients assigned to upper GI endoscopy following bariatric surgery in Riyadh was 39%. This finding was quite similar to our Hail’s patients (35%) but much lower than Al-Kharj (69%).…”

Section: Discussionmentioning

confidence: 99%

Upper gastrointestinal tract involvement in the management of bariatric patients in the Kingdom of Saudi Arabia

Zacharakis

Almasoud

Al-Zahrani

et al. 2021

aog

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Background Preoperative esophagogastroduodenoscopy (EGD) may affect the management of bariatric patients although this is not consistent universally. The present prospective study evaluated the effect of preoperative EGD findings in obese Saudi patients, including upper digestive symptoms (UDS) and comorbidities, on their planned surgery. Methods From January 2018 to May 2019, we conducted a 4-center retrospective observational study to evaluate the endoscopic findings among Saudi patients aged 18-65 years with a body mass index (BMI) >40 kg/m 2 . Preoperative data included UDS, comorbidities, Helicobacter pylori ( H. pylori ) infection assessed during a histopathological examination, and EGD findings. Results 717 patients underwent EGDs, and 432 underwent bariatric surgery. The mean BMI was 44.3±6.3 kg/m 2 , and the mean age was 27.8±11.8 years. The overall UDS prevalence was 49%, with the most frequent being gastroesophageal reflux disease 54% (387/717), followed by dyspepsia 44% (315/717). H. pylori infection was detected in 287/672 (42.4%) patients. The total percentage of patients with normal EGD was 36% (258/717). A delayed bariatric procedure was performed in 15% of the patients for the following reasons: 2.3% had large polyps of >1 cm (either hyperplastic or cystic polyps); 1.62% had esophagitis grade C and D based on the Los Angeles classification; 0.7% had Barrett’s esophagus; and 5.7% had peptic ulcer disease. Conclusions Our findings confirmed that obesity carries a profound health burden with a significant impact on health expenditures. Routine preoperative EGD in the obese Saudi population appears to be mandatory to identify factors that may change, delay, or postpone the bariatric procedure.

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Section: Discussionmentioning

confidence: 99%

Upper gastrointestinal tract involvement in the management of bariatric patients in the Kingdom of Saudi Arabia

Zacharakis

Almasoud

Al-Zahrani

et al. 2021

aog

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“…This result matched with another study conducted in Al Kharj region in Riyadh by Alanazi et al 19 who reported H. pylori presence among the involved cases was (62.2%). In several researches all-over the world in United States, Brazil and China, the H. pylori prevalence between dyspeptic patients was 28.9%, 57%, and 84% respectively Ramis et al 20 Another study by Aleid et al 21 reported that the H. pylori prevalence in studied cases in Riyadh was 39%. This data was lower than this report.…”

Section: Discussionmentioning

confidence: 97%

Detection of vacA, cagA and iceA genes of H. pylori in dyspeptic patients and their association with clinical data and histopathological abnormalities

khater

AlFaki²

2022

Egyptian Journal of Medical Microbiology

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Background: Despite that most H. pylori infections are asymptomatic, some can develop major diseases like peptic ulcer and adenocarcinoma of stomach. Objectives: This study aimed to study the prevalence of H. pylori using real time PCR. Furthermore, detection of the cagA, iceA1, iceA2, vacA virulence genes and their relationship to clinical and histopathological alterations. Methods: Two gastric specimens were taken from every patient endoscopically, one of them was sent to histopathological analysis and the second biobsy was minced into tiny parts for real time PCR assay. Results: The results revealed that the prevalence of H. pylori was 66.67%. Thirty one (50%) of the studied strains harbored cagA gene. IceA gene was positive in 41.94%. The vacA gene was detected in all 62 (100%) samples. Many vacA gene subtypes were detected, the highest found was s1as1bm 20.97%. A significant association was detected between the endoscopic features and vacA presence. The subtypes of vacA: s2, m2,s1a1b, s1as1bm2, were related to gastritis, while s1a, s1b, m1were related to duodenal and stomach ulcers. No significant association between cagA presence and endoscopical or histopathological findings, but more than 66% of duodenal ulcers had positive cagA gene. There was a significant association between the iceA1 and iceA2 genes presence with gastritis and gastric ulcer. Conclusion the study of H. pylori virulence factors allows the clinician to identify high-risk patients caused by H. pylori infections.

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“…Lastly, proceeding with bariatric surgeries without preoperative EGD will risk the surgeons facing surprising incidentalomas that are considered contraindications for surgery. The diagnosis of malignancy in a suspicious endoscopic lesion or the presence of oesophageal varices, for instance, might lead to cancellation of an original bariatric surgery plan [33]. On the other hand, performing a routine preoperative EGD for all bariatric surgery patients is not without any drawbacks.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Assessment Prior to Bariatric Surgery in Saudi Arabia

Aljaroudi¹,

Makki²,

Almulaify³

et al. 2023

Cureus

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Background: There are marked local inconsistencies in the Arabian Peninsula about the role of preoperative esophagogastroduodenoscopy (EGD) in bariatric surgery. Thus, this study was conducted to determine the frequency of endoscopic and histological findings in the Saudi population presenting for pre-bariatric surgery evaluation.Material and Methods: This was a retrospective study that included all the patients who were evaluated by EGD at Dammam Medical Complex, Dammam, Saudi Arabia, between 2018 and 2021 as a part of their prebariatric-surgery evaluation.Results: A total of 684 patients were included. They consisted of 250 male and 434 female patients (36.5% and 63.5%, respectively). The mean ± standard deviation for the patients' age and body mass index (BMI) were 36.4±10.6 years and 44.6±5.1 kg/m 2 , respectively. Significant endoscopic or histopathological findings as defined by the presence of large (≥ 2 cm) hiatus hernia, esophagitis, gastroesophageal reflux disease (GERD), Barrett esophagus, gastric ulcer, duodenal ulcer, or intestinal metaplasia were found in 143 patients (20.9%); 364 patients (53.2%) were diagnosed to have Helicobacter pylori infection. Conclusion:The high number of significant endoscopic and histopathological findings in our study supports the routine use of preoperative EGD in all bariatric surgery patients. However, omitting EGD before Rouxen-Y gastric bypass (RYGB) in asymptomatic patients is still reasonable as the most frequently found significant findings, esophagitis, and hiatus hernia, are less likely to impact the operative plans in RYGB. Similarly, active surveillance and treatment of H. pylori infections in obese patients are important but it is not clear whether H. pylori eradication should be done before bariatric surgery.

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The utility of esophagogastroduodenoscopy and Helicobacter pylori screening in the preoperative assessment of patients undergoing bariatric surgery: A cross-sectional, single-center study in Saudi Arabia

Cited by 7 publications

References 19 publications

Upper gastrointestinal tract involvement in the management of bariatric patients in the Kingdom of Saudi Arabia

Upper gastrointestinal tract involvement in the management of bariatric patients in the Kingdom of Saudi Arabia

Detection of vacA, cagA and iceA genes of H. pylori in dyspeptic patients and their association with clinical data and histopathological abnormalities

Endoscopic Assessment Prior to Bariatric Surgery in Saudi Arabia

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