The role of endoscopy in the bariatric surgery patient asge standards of practice committee

This is one of a series of statements discussing the use of GI endoscopy in common clinical situations. The Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy (ASGE) prepared this text in conjunction with representatives from the Society of Gastrointestinal and Endoscopic Surgeons (SAGES) and the American Society for Metabolic and Bariatric Surgery (ASMBS). In preparing this document, MEDLINE and PubMed databases were used to search for publications between January 1980 and December 2013 pertaining to this topic by using the key words ‘‘bariatric surgery’’ and ‘‘endoscopy.’’ The search was supplemented by accessing the ‘‘related articles’’ feature of PubMed with articles identified on MEDLINE and PubMed as the references. Additional references were obtained from the bibliogra-phies of the identified articles and from recommendations of expert consultants. When few or no data were available from well-designed prospective trials, emphasis was given to results from large series and reports from recognized experts. Weaker recommendations are indicated by phrases such as ‘‘We suggest…,’’ whereas stronger recommendations are stated as ‘‘We recommend….’’ The strength of individual recommendations was based on both the ag-gregate evidence quality (Table 1) [1] and an assessment of the anticipated benefits and harms. ASGE position statements for appropriate use of en-doscopy are based on a critical review of the available data and expert consensus at the time that the documents are drafted. Further controlled clinical studies may be needed to clarify aspects of this document. This document may be revised as necessary to account for changes in technology, new data, or other aspects of clinical practice and is solely intended to be an educational device to pro-vide information that may assist endoscopists in providing care to patients. This document is not a rule and should not be construed as establishing a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment. Clinical decisions in any particular case involve a complex analysis of the patient’s condition and available courses of action. Therefore, clinical con-siderations may lead an endoscopist to take a course of action that varies from the recommendations and sugges-tions proposed in this document.