Long-term postoperative endoscopic findings after gastric bypass procedure: a co-occurrence analysis

Abstract

A multitude of endoscopic findings post-gastric bypass procedures have been previously reported in the literature, but to our knowledge, no present rules exist that could guide clinicians regarding which findings should be actively sought, once an initial finding is identified. Objective - To identify co-occurrence patterns among endoscopic findings of patients having undergone past gastric bypass procedure. Methods - Our registry involves all consecutive patients undergoing an upper endoscopic evaluation after a gastric bypass procedure. We collected information on the presence of the endoscopic findings in post-gastric bypass surgery patients. Co-occurrence evaluation involved the use of intersection, cluster and item factor analyses. Results - A total of 396 endoscopic evaluations were made on 339 patients. Most patients were female (81.1%), with an average BMI of 31.88±6.7 at the time of endoscopy. Esophagitis was the most common isolated finding (35.3%). Endoscopic findings clustered around two groups, (1) the ring-related complications involving ring displacement, ring slips and gastric pouch, while (2) stenosis-related findings involved dilation and stenosis (P<0.01). Conclusion - While most endoscopic findings after gastric bypass endoscopic procedures are isolated, ring and stenosis-related clusters should be used as a set of rules by clinicians, as it might enhance their probability of finding co-occurring conditions.