Post-Bariatric Surgery Complications and the Role of Endoscopic Intervention

The prevalence of obesity across the world, especially in the United States, remains at epidemic proportions, creating significant health complications in these patients and posing challenges for overcoming numerous related conditions. Over the years, the surgical approach to the management and treatment of obesity and associated morbidities has continued to increase in use and has been an effective treatment method. Various approaches to surgical management include Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), adjustable gastric banding, biliopancreatic diversion with duodenal switch (DS), and endoscopic intragastric balloons. Endoscopy has remained a mainstay approach to evaluating post-operative changes and complications following these procedures. In this scoping review, we discuss the indications and optimal timing for endoscopic evaluation post-bariatric surgical intervention, common endoscopic findings, endoscopic therapeutic techniques and challenges, as well as future directions in the field of post-operative endoscopy. We conclude that while some complications require immediate surgical or radiologic intervention prior to endoscopy, other complications may be evaluated with endoscopy.