IFSO guidelines on surveillance OGD after LSG
he International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) position is clear towards this matter. The IFSO recommends a surveillance endoscopy, routinely after a LSG.
The guidelines of the IFSO are:
(1) LSG is secure and efficient metabolic procedure;
(2) The presence of Barrett’s esophagus is considered as a contra-indication for SG;
(3) The presence of Barrett’s esophagus or the severity of an esophagitis doesn’t always correlate with the symptomatology degree;
(4) In two different longitudinal studies, the novo Barrett’s esophagus was found in the case of 15% to 17% of the patients without any correlation between the symptomatology and the endoscopy results;
(5) Consequently, a pre-operative screening endoscopy and a surveillance post-operative one should be mandatory after one, three and five years after a LSG and later each 10 years;
(6) The presence of a novo Barrett’s esophagus after a Sleeve should lead to a more frequent surveillance and the conversion to a gastric bypass or other therapies