Is Routine Upper Endoscopy and H. pylori Testing Indicated in Advance of Bariatric Surgery?

Bariatric surgery is the only proven method for sustained weight loss in the obese population and is becoming increasingly more common. Multiple bariatric operations are available, and each procedure comes with unique possible adverse outcomes. Preoperative testing with upper endoscopy and Helicobacter pylori (H. pylori) screening have been proposed as methods to reduce postoperative complications. However, the majority of data regarding preoperative evaluation in bariatric surgery is derived from single center, non-standardized, retrospective chart reviews, and even similar results from different centers are interpreted differently. This has led to conflicting guidelines from international societies. Herein, we will review the current literature to discuss the utility of preoperative endoscopy and H. pylori testing.