| Abstract: | In industrialized countries, surgicalgastroplasty is performed more and more frequently inpatients with morbid obesity. The aims of thisprospective study were to determine the incidence ofupper gastrointestinal lesions in obese patients and to assess theplace of digestive endoscopy in symptomatic patientsafter gastroplasty. A consecutive group of 159 obesepatients were studied before and after vertical banded gastroplasty. In the preoperative evaluation,reflux esophagitis and gastroduodenal lesions wereendoscopically observed in 31% and 37% of the patients,respectively. Interestingly, the majority of the obese patients with upper gastrointestinallesions were asymptomatic. In the postoperativefollow-up period, 55 of the 159 patients complained ofupper gastrointestinal symptoms such as vomiting (72%), esophageal reflux (17%), and epigastric pain(3%). Stenosis of the outlet of the gastric pouch wasdescribed in 40 of the 55 symptomatic patients.Esophagitis was observed in 60% of these patients.Endoscopic dilation using Savary bougies or TTS balloonwas successfully performed in all the patients withsymptomatic stenosis of the gastric outlet. Foodimpaction was endoscopically removed in four patients.Thus, we recommend performing an uppergastrointestinal endoscopy in obese patients who arecandidates for surgical gastroplasty because of the highincidence of upper gastrointestinal peptic lesions.Endoscopy is also helpful in patients with digestivedisorders occurring after gastroplasty in order todefine and to treat the lesions. |
