Gastro-esophageal diagnostic workup before bariatric surgery or endoscopic treatment for obesity: position statement of the International Society of Diseases of the Esophagus

Author:

Visaggi Pierfrancesco123ORCID,Ghisa Matteo45ORCID,Barberio Brigida67,Chiu Philip W89,Ishihara Ryu10,Kohn Geoffrey P1112,Morozov Sergey1314,Thompson Sarah K15ORCID,Wong Ian89ORCID,Hassan Cesare161718,Savarino Edoardo Vincenzo6719ORCID

Affiliation:

1. Gastroenterology Unit , Department of Translational Research and New Technologies in Medicine and Surgery, , Pisa , Italy

2. University of Pisa , Department of Translational Research and New Technologies in Medicine and Surgery, , Pisa , Italy

3. Digestive Endoscopy Unit, Pisa University Hospital , Pisa , Italy

4. Digestive Endoscopy Unit , Department of Gastroenterology, , Padua , Italy

5. Padua University Hospital , Department of Gastroenterology, , Padua , Italy

6. Division of Gastroenterology , Department of Surgery, Oncology and Gastroenterology, , Padua , Italy

7. University of Padua , Department of Surgery, Oncology and Gastroenterology, , Padua , Italy

8. Department of Surgery , School of Clinical Medicine, LKS Faculty of Medicine, , Hong Kong SAR , China

9. The University of Hong Kong , School of Clinical Medicine, LKS Faculty of Medicine, , Hong Kong SAR , China

10. Department of Gastrointestinal Oncology, Osaka International Cancer Institute , Osaka , Japan

11. Department of Surgery, Monash University Eastern Health Clinical School , Melbourne , Australia

12. Melbourne Upper GI Surgical Group, c/o Cabrini Hospital , Malvern , Australia

13. Department of Gastroenterology , Hepatology and Nutrition, , Moscow , Russia

14. Federal Research Center of Nutrition, Biotechnology and Food Safety , Hepatology and Nutrition, , Moscow , Russia

15. College of Medicine & Public Health, Flinders University , Bedford Park , Australia

16. Department of Biomedical Sciences, Humanitas University , Milan , Italy

17. Department of Biomedical Sciences , Endoscopy Unit, , Milan , Italy

18. IRCCS Humanitas Clinical and Research Center , Endoscopy Unit, , Milan , Italy

19. Gastroenterology Unit, Azienda Ospedale Università of Padua , Padua , Italy

Abstract

Summary Obesity is a chronic and multifactorial condition characterized by abnormal weight gain due to excessive adipose tissue accumulation that represents a growing worldwide challenge for public health. In addition, obese patients have an increased risk of hiatal hernia, esophageal, and gastric dysfunction, as well as gastroesophageal reflux disease, which has a prevalence over 40% in those seeking endoscopic or surgical intervention. Surgery has been demonstrated to be the most effective treatment for severe obesity in terms of long-term weight loss, comorbidities, and quality of life improvements and overall mortality decrease. The recent emergence of bariatric endoscopic techniques promises less invasive, more cost-effective, and reproducible approaches to the treatment of obesity. With the endorsement of the International Society for Diseases of the Esophagus, we started a Delphi process to develop consensus statements on the most appropriate diagnostic workup to preoperatively assess gastroesophageal function before bariatric surgical or endoscopic interventions. The Consensus Working Group comprised 11 international experts from five countries. The group consisted of gastroenterologists and surgeons with a large expertise with regard to gastroesophageal reflux disease, bariatric surgery and endoscopy, and physiology. Ten statements were selected, on the basis of the agreement level and clinical relevance, which represent an evidence and experience-based consensus of the International Society for Diseases of the Esophagus.

Publisher

Oxford University Press (OUP)

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