Role of Esophagogastroduodenoscopy in the Pediatric Metabolic and Bariatric Surgery Patient

Publication Date: July 18, 2021
Last Updated: March 14, 2022

Recommendation 1

1. There is insufficient evidence to recommend for or against routine preoperative EGD in asymptomatic pediatric patients undergoing VSG, this decision should be based on the surgeon’s discretion. (M)

Recommendation 2

Pediatric patients undergoing RYGB as an initial procedure, could be considered for preoperative EGD based on ASMBS adult Position Statement due to the difficulty evaluating their gastrointestinal tract post operatively. (M)

Recommendation 3

3. Routine preoperative EGD with biopsy is recommended in all pediatric patients with significant upper gastrointestinal symptoms. (H)

Recommendation 4

4. Pediatric patients should be screened annually for gastrointestinal symptoms by their pediatrician or primary care provider and those with significant upper gastrointestinal symptoms should undergo timely endoscopic evaluation. (H)

Recommendation 5

5. Consider a baseline post-VSG screening EGD in all pediatric patients when transitioning to adult care due to the risk of poor follow-up and asymptomatic reflux. (L)

Recommendation 6

6. Preoperative and/or intraoperative EGD in pediatric patients with prior foregut or MBS could be considered. (M)

Recommendation Grading




Role of Esophagogastroduodenoscopy in the Pediatric Metabolic and Bariatric Surgery Patient

Authoring Organization

Publication Month/Year

July 18, 2021

Last Updated Month/Year

August 14, 2023

Document Type


Country of Publication


Inclusion Criteria

Male, Female, Adolescent, Child

Health Care Settings

Ambulatory, Outpatient, Operating and recovery room

Intended Users

Nurse, nurse practitioner, physician, physician assistant



Diseases/Conditions (MeSH)

D050110 - Bariatric Surgery, D015431 - Weight Loss


bariatric surgery, pediatric, esophagogastroduodenoscopy (EGD), Esophagogastroduodenoscopy

Source Citation

El Haija MA, Browne NT, Griggs CL, Herdes RE, Michalsky MP, Ogle SB, Zitsman JL, Pratt JSA; Pediatric Committee of the ASMBS. Considerations on the role of esophagogastroduodenoscopy in the pediatric metabolic and bariatric surgery patient. Surg Obes Relat Dis. 2021 Nov;17(11):1834-1839. doi: 10.1016/j.soard.2021.07.010. Epub 2021 Jul 26. PMID: 34417117.