Objective:

To assess the necessity of routine preoperative esophagogastroduodenoscopy (p-EGD) in patients undergoing bariatric surgery (BS) and its implications for clinical practice.

Key Findings:

• Routine p-EGD may not significantly alter management in asymptomatic patients, suggesting a need for selective screening.
• Only 2% of asymptomatic patients had abnormalities detected at p-EGD, none affecting treatment plans.
• 93.2% of BS patients had negative p-EGD findings or no effect on preoperative management.
• Inconsistencies exist in recommendations for p-EGD across different regions and practices, highlighting the need for standardized guidelines.

Interpretation:

The evidence suggests that routine p-EGD may not be necessary for all bariatric surgery patients, particularly asymptomatic individuals, due to low detection rates of clinically significant abnormalities and potential impacts on healthcare resources.

Limitations:

• Potential overuse of p-EGD may negatively impact healthcare quality and resources, emphasizing the need for selective screening.
• Variability in practice guidelines and patient populations may affect generalizability, necessitating further research.

Conclusion:

Routine preoperative esophagogastroduodenoscopy is not justified for all bariatric surgery patients, especially those who are asymptomatic, as it does not significantly influence management or outcomes; selective screening may be more appropriate.