{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T05:51:10Z","timestamp":1792302670240,"version":"4.4.0"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2020,2,24]],"date-time":"2020-02-24T00:00:00Z","timestamp":1582502400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,2,24]],"date-time":"2020-02-24T00:00:00Z","timestamp":1582502400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["OBES SURG"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>The role of preoperative upper-gastrointestinal (GI) gastroscopy has been discussed with controversy in bariatric surgery. The aim of this study was to evaluate the incidence of upper-GI pathologies detected via endoscopy prior to bariatric surgery along with their clinical significance for patients\u2019 management.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Material and Methods<\/jats:title>\n                <jats:p>In our single center prospectively established database of obese patients, who underwent bariatric surgery from January 2011 to December 2017, we retrospectively analyzed the perioperative endoscopic findings along with their influence on patients\u2019 management.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In total, 636 obese patients with median BMI (body mass index) of 49\u00a0kg\/m<jats:sup>2<\/jats:sup> [range 31\u201392] received an upper-GI endoscopy prior to bariatric surgery. Among the surgical procedures, laparoscopic Roux-Y-gastric bypass (72.6%; <jats:italic>n<\/jats:italic>\u2009=\u2009462) was the most frequent operation. Endoscopically detected pathological conditions were peptic ulcer 3.5% (22\/636), Helicobacter pylori (Hp) gastritis 22.4% (143\/636), and gastric or duodenal polyps 6.8% (43\/636). Reflux esophagitis could be detected in 139\/636 patients (21.9%). Barrett\u2019s esophagus (BE) was histologically diagnosed in 95 cases (15.0%), whereas BE was suspected endoscopically in 75 cases (11.3%) only. Esophageal adenocarcinomas were detected in 3 cases (0.5%). Change of the operative strategy due to endoscopically or histologically detected pathologic findings had to be performed in 10 cases (1.6%).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Preoperative upper-GI endoscopy identifies a wide range of abnormal endoscopic findings in obese patients, which may have a significant impact on decision-making, particularly regarding the most suitable bariatric procedure and the appropriate follow-up. Therefore, preoperative upper-GI endoscopy should be considered in all obese patients prior to bariatric procedure.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s11695-020-04485-5","type":"journal-article","created":{"date-parts":[[2020,2,24]],"date-time":"2020-02-24T12:06:58Z","timestamp":1582546018000},"page":"2076-2084","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["Preoperative Upper-GI Endoscopy Prior to Bariatric Surgery: Essential or Optional?"],"prefix":"10.1007","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5936-0217","authenticated-orcid":false,"given":"Yusef","family":"Moulla","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orestis","family":"Lyros","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Mehdorn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Undine","family":"Lange","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haitham","family":"Hamade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rene","family":"Thieme","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albrecht","family":"Hoffmeister","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Feisthammel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Bl\u00fcher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boris","family":"Jansen-Winkeln","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ines","family":"Gockel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arne","family":"Dietrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,2,24]]},"reference":[{"issue":"3","key":"4485_CR1","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1001\/jamasurg.2013.3654","volume":"149","author":"SH Chang","year":"2014","unstructured":"Chang SH, Stoll CR, Song J, et al. The effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis, 2003-2012. JAMA Surg. 2014;149(3):275\u201387.","journal-title":"JAMA Surg"},{"issue":"9","key":"4485_CR2","doi-asserted-by":"publisher","first-page":"761","DOI":"10.1002\/ajim.22637","volume":"59","author":"N Icitovic","year":"2016","unstructured":"Icitovic N et al. The association between body mass index and gastroesophageal reflux disease in the world trade center health program general responder cohort. Am J Ind Med. 2016;59(9):761\u20136.","journal-title":"Am J Ind Med"},{"issue":"7","key":"4485_CR3","doi-asserted-by":"publisher","first-page":"564","DOI":"10.1111\/j.1442-2050.2009.00967.x","volume":"22","author":"D Seidel","year":"2009","unstructured":"Seidel D, Muangpaisan W, Hiro H, et al. The association between body mass index and Barrett's esophagus: a systematic review. Dis Esophagus. 2009;22(7):564\u201370.","journal-title":"Dis Esophagus"},{"issue":"9","key":"4485_CR4","doi-asserted-by":"publisher","first-page":"2753","DOI":"10.1007\/s11695-018-3230-z","volume":"28","author":"M D'Silva","year":"2018","unstructured":"D'Silva M, Bhasker AG, Kantharia NS, et al. High-percentage pathological findings in obese patients suggest that Esophago-gastro-duodenoscopy should be made mandatory prior to bariatric surgery. Obes Surg. 2018;28(9):2753\u20139.","journal-title":"Obes Surg"},{"issue":"2","key":"4485_CR5","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1381\/096089206775565177","volume":"16","author":"TM Zeni","year":"2006","unstructured":"Zeni TM, Frantzides CT, Mahr C, et al. Value of preoperative upper endoscopy in patients undergoing laparoscopic gastric bypass. Obes Surg. 2006;16(2):142\u20136.","journal-title":"Obes Surg"},{"key":"4485_CR6","doi-asserted-by":"crossref","unstructured":"Dietrich, A. S3-Leitlinie: Chirurgie der Adipositas und metabolischer Erkrankungen. 2018; Available from: https:\/\/www.awmf.org\/uploads\/tx_szleitlinien\/088-001l_S3_Chirurgie-Adipositas-metabolische-Erkrankugen_2018-02.pdf.","DOI":"10.1055\/s-0043-109360"},{"issue":"5","key":"4485_CR7","doi-asserted-by":"publisher","first-page":"1063","DOI":"10.1016\/j.gie.2014.09.044","volume":"81","author":"American Societyfor Gastrointestinal Endoscopy Standards of Practice, C","year":"2015","unstructured":"American Societyfor Gastrointestinal Endoscopy Standards of Practice, C et al. The role of endoscopy in the bariatric surgery patient. Gastrointest Endosc. 2015;81(5):1063\u201372.","journal-title":"Gastrointest Endosc"},{"issue":"1","key":"4485_CR8","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1111\/j.1442-2050.2010.01092.x","volume":"24","author":"RM Genta","year":"2011","unstructured":"Genta RM, Spechler SJ, Kielhorn AF. The Los Angeles and Savary-miller systems for grading esophagitis: utilization and correlation with histology. Dis Esophagus. 2011;24(1):10\u20137.","journal-title":"Dis Esophagus"},{"issue":"Suppl 1","key":"4485_CR9","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1111\/j.1440-1746.2010.06536.x","volume":"26","author":"P Sipponen","year":"2011","unstructured":"Sipponen P, Price AB. The Sydney system for classification of gastritis 20 years ago. J Gastroenterol Hepatol. 2011;26(Suppl 1):31\u20134.","journal-title":"J Gastroenterol Hepatol"},{"issue":"11","key":"4485_CR10","doi-asserted-by":"publisher","first-page":"1299","DOI":"10.1055\/s-0034-1385202","volume":"52","author":"H Koop","year":"2014","unstructured":"Koop H, Fuchs KH, Labenz J, et al. S2k guideline: gastroesophageal reflux disease guided by the German Society of Gastroenterology: AWMF register no. 021-013. Z Gastroenterol. 2014;52(11):1299\u2013346.","journal-title":"Z Gastroenterol"},{"issue":"6","key":"4485_CR11","doi-asserted-by":"publisher","first-page":"1858","DOI":"10.1007\/s11695-019-03782-y","volume":"29","author":"O Lyros","year":"2019","unstructured":"Lyros O, Moulla Y, Mehdorn M, et al. Coincidental detection of gastrointestinal stromal tumors during laparoscopic bariatric procedures\u2014data and treatment strategy of a German reference center. Obes Surg. 2019;29(6):1858\u201366.","journal-title":"Obes Surg"},{"key":"4485_CR12","doi-asserted-by":"crossref","unstructured":"Colman RJ, et al. Upper GI endoscopy in adolescents with severe obesity prior to vertical sleeve gastrectomy. J Pediatr Gastroenterol Nutr. 2019;69(3):287\u201391.","DOI":"10.1097\/MPG.0000000000002371"},{"issue":"1","key":"4485_CR13","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1007\/s11695-016-2243-8","volume":"27","author":"J Lee","year":"2017","unstructured":"Lee J, Wong SK, Liu SY, et al. Is preoperative upper gastrointestinal endoscopy in obese patients undergoing bariatric surgery mandatory? An Asian Perspective. Obes Surg. 2017;27(1):44\u201350.","journal-title":"Obes Surg"},{"issue":"8","key":"4485_CR14","doi-asserted-by":"publisher","first-page":"1938","DOI":"10.1007\/s11695-017-2622-9","volume":"27","author":"S Wolter","year":"2017","unstructured":"Wolter S, Dupr\u00e9e A, Miro J, et al. Upper gastrointestinal endoscopy prior to bariatric surgery-mandatory or expendable? An analysis of 801 cases. Obes Surg. 2017;27(8):1938\u201343.","journal-title":"Obes Surg"},{"issue":"10","key":"4485_CR15","doi-asserted-by":"publisher","first-page":"409","DOI":"10.4253\/wjge.v8.i10.409","volume":"8","author":"ME Abd Ellatif","year":"2016","unstructured":"Abd Ellatif ME, Alfalah H, Asker WA, et al. Place of upper endoscopy before and after bariatric surgery: a multicenter experience with 3219 patients. World J Gastrointest Endosc. 2016;8(10):409\u201317.","journal-title":"World J Gastrointest Endosc"},{"issue":"9","key":"4485_CR16","doi-asserted-by":"publisher","first-page":"2156","DOI":"10.1007\/s11695-016-2060-0","volume":"26","author":"JY Ng","year":"2016","unstructured":"Ng JY, Cheng AKS, Kim G, et al. Is elective gastroscopy prior to bariatric surgery in an Asian cohort worthwhile? Obes Surg. 2016;26(9):2156\u201360.","journal-title":"Obes Surg"},{"issue":"3","key":"4485_CR17","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1016\/j.soard.2014.01.015","volume":"10","author":"A Schigt","year":"2014","unstructured":"Schigt A et al. Is esophagogastroduodenoscopy before roux-en-Y gastric bypass or sleeve gastrectomy mandatory? Surg Obes Relat Dis. 2014;10(3):411\u20137. quiz 565-6","journal-title":"Surg Obes Relat Dis"},{"issue":"6","key":"4485_CR18","doi-asserted-by":"publisher","first-page":"736","DOI":"10.1007\/s11695-013-0956-5","volume":"23","author":"P Peromaa-Haavisto","year":"2013","unstructured":"Peromaa-Haavisto P, Victorzon M. Is routine preoperative upper GI endoscopy needed prior to gastric bypass? Obes Surg. 2013;23(6):736\u20139.","journal-title":"Obes Surg"},{"issue":"42","key":"4485_CR19","first-page":"705","volume":"115","author":"A Dietrich","year":"2018","unstructured":"Dietrich A, Aberle J, Wirth A, et al. Obesity surgery and the treatment of metabolic diseases. Dtsch Arztebl Int. 2018;115(42):705\u201311.","journal-title":"Dtsch Arztebl Int"},{"issue":"Suppl 1","key":"4485_CR20","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1002\/oby.20461","volume":"21","author":"JI Mechanick","year":"2013","unstructured":"Mechanick JI et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient--2013 update: cosponsored by American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & bariatric surgery. Obesity (Silver Spring). 2013;21(Suppl 1):S1\u201327.","journal-title":"Obesity (Silver Spring)"},{"issue":"1","key":"4485_CR21","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1007\/s11695-013-1079-8","volume":"24","author":"M Fried","year":"2014","unstructured":"Fried M, Yumuk V, Oppert JM, et al. Interdisciplinary European guidelines on metabolic and bariatric surgery. Obes Surg. 2014;24(1):42\u201355.","journal-title":"Obes Surg"},{"issue":"1","key":"4485_CR22","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1007\/s11695-017-2813-4","volume":"28","author":"A Salama","year":"2018","unstructured":"Salama A, Saafan T, el Ansari W, et al. Is routine preoperative esophagogastroduodenoscopy screening necessary prior to laparoscopic sleeve Gastrectomy? Review of 1555 cases and comparison with current literature. Obes Surg. 2018;28(1):52\u201360.","journal-title":"Obes Surg"},{"issue":"12","key":"4485_CR23","doi-asserted-by":"publisher","first-page":"2961","DOI":"10.1007\/s11695-016-2232-y","volume":"26","author":"M Parikh","year":"2016","unstructured":"Parikh M, Liu J, Vieira D, et al. Preoperative endoscopy prior to bariatric surgery: a systematic review and meta-analysis of the literature. Obes Surg. 2016;26(12):2961\u20136.","journal-title":"Obes Surg"},{"issue":"4","key":"4485_CR24","doi-asserted-by":"publisher","first-page":"127","DOI":"10.4292\/wjgpt.v6.i4.127","volume":"6","author":"SS Chang","year":"2015","unstructured":"Chang SS, Hu HY. Helicobacter pylori: effect of coexisting diseases and update on treatment regimens. World J Gastrointest Pharmacol Ther. 2015;6(4):127\u201336.","journal-title":"World J Gastrointest Pharmacol Ther"},{"issue":"2","key":"4485_CR25","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1053\/j.gastro.2017.04.022","volume":"153","author":"JKY Hooi","year":"2017","unstructured":"Hooi JKY et al. Global prevalence of helicobacter pylori infection: systematic review and meta-analysis. Gastroenterology. 2017;153(2):420\u20139.","journal-title":"Gastroenterology"},{"issue":"4","key":"4485_CR26","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1097\/SLA.0000000000001300","volume":"263","author":"E Sverden","year":"2016","unstructured":"Sverden E et al. Risk factors for marginal ulcer after gastric bypass surgery for obesity: a population-based cohort study. Ann Surg. 2016;263(4):733\u20137.","journal-title":"Ann Surg"},{"issue":"9","key":"4485_CR27","doi-asserted-by":"publisher","first-page":"2105","DOI":"10.1007\/s11695-016-2056-9","volume":"26","author":"SR Fernandes","year":"2016","unstructured":"Fernandes SR et al. The role of routine upper gastrointestinal endoscopy before bariatric surgery. Obes Surg. 2016;26(9):2105\u201310.","journal-title":"Obes Surg"},{"issue":"Suppl 1","key":"4485_CR28","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1046\/j.1365-2036.11.s1.5.x","volume":"11","author":"EJ Kuipers","year":"1997","unstructured":"Kuipers EJ. Helicobacter pylori and the risk and management of associated diseases: gastritis, ulcer disease, atrophic gastritis and gastric cancer. Aliment Pharmacol Ther. 1997;11(Suppl 1):71\u201388.","journal-title":"Aliment Pharmacol Ther"},{"issue":"5","key":"4485_CR29","doi-asserted-by":"publisher","first-page":"1075","DOI":"10.1007\/s11695-015-1861-x","volume":"26","author":"M Carabotti","year":"2016","unstructured":"Carabotti M, Avallone M, Cereatti F, et al. Usefulness of upper gastrointestinal symptoms as a driver to prescribe gastroscopy in obese patients candidate to bariatric surgery. A Prospective Study. Obes Surg. 2016;26(5):1075\u201380.","journal-title":"Obes Surg"},{"issue":"1","key":"4485_CR30","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/j.gtc.2009.12.002","volume":"39","author":"G Anand","year":"2010","unstructured":"Anand G, Katz PO. Gastroesophageal reflux disease and obesity. Gastroenterol Clin N Am. 2010;39(1):39\u201346.","journal-title":"Gastroenterol Clin N Am"},{"issue":"9","key":"4485_CR31","doi-asserted-by":"publisher","first-page":"2307","DOI":"10.1007\/s10620-008-0413-9","volume":"53","author":"H El-Serag","year":"2008","unstructured":"El-Serag H. The association between obesity and GERD: a review of the epidemiological evidence. Dig Dis Sci. 2008;53(9):2307\u201312.","journal-title":"Dig Dis Sci"},{"issue":"3","key":"4485_CR32","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1007\/s11605-007-0097-z","volume":"11","author":"FA Herbella","year":"2007","unstructured":"Herbella FA, Sweet MP, Tedesco P, et al. Gastroesophageal reflux disease and obesity. Pathophysiology and implications for treatment. J Gastrointest Surg. 2007;11(3):286\u201390.","journal-title":"J Gastrointest Surg"},{"issue":"12","key":"4485_CR33","doi-asserted-by":"publisher","first-page":"2430","DOI":"10.1007\/s11695-015-1906-1","volume":"25","author":"J Melissas","year":"2015","unstructured":"Melissas J, Braghetto I, Molina JC, et al. Gastroesophageal reflux disease and sleeve Gastrectomy. Obes Surg. 2015;25(12):2430\u20135.","journal-title":"Obes Surg"},{"issue":"12","key":"4485_CR34","doi-asserted-by":"publisher","first-page":"3092","DOI":"10.1007\/s11695-017-2748-9","volume":"27","author":"DM Felsenreich","year":"2017","unstructured":"Felsenreich DM et al. Reflux, sleeve dilation, and Barrett's esophagus after laparoscopic sleeve Gastrectomy: long-term follow-up. Obes Surg. 2017;27(12):3092\u2013101.","journal-title":"Obes Surg"},{"issue":"2","key":"4485_CR35","doi-asserted-by":"publisher","first-page":"930","DOI":"10.1007\/s00464-017-5768-6","volume":"32","author":"B Andrew","year":"2018","unstructured":"Andrew B, Alley JB, Aguilar CE, et al. Barrett's esophagus before and after roux-en-Y gastric bypass for severe obesity. Surg Endosc. 2018;32(2):930\u20136.","journal-title":"Surg Endosc"},{"issue":"3","key":"4485_CR36","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1007\/s13304-018-0579-4","volume":"70","author":"V Gorodner","year":"2018","unstructured":"Gorodner V, Viscido G, Signorini F, et al. Gastroesophageal reflux disease and morbid obesity: evaluation and treatment. Updat Surg. 2018;70(3):331\u20137.","journal-title":"Updat Surg"},{"issue":"1","key":"4485_CR37","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1038\/ajg.2015.322","volume":"111","author":"NJ Shaheen","year":"2016","unstructured":"Shaheen NJ et al. ACG clinical guideline: diagnosis and Management of Barrett's esophagus. Am J Gastroenterol. 2016;111(1):30\u201350. quiz 51","journal-title":"Am J Gastroenterol"},{"issue":"8","key":"4485_CR38","doi-asserted-by":"publisher","first-page":"1997","DOI":"10.1007\/s10620-018-5161-x","volume":"63","author":"EJ Kuipers","year":"2018","unstructured":"Kuipers EJ, Spaander MC. Natural history of Barrett's esophagus. Dig Dis Sci. 2018;63(8):1997\u20132004.","journal-title":"Dig Dis Sci"},{"issue":"8","key":"4485_CR39","doi-asserted-by":"publisher","first-page":"1151","DOI":"10.1016\/j.ejca.2005.12.024","volume":"42","author":"AM Ryan","year":"2006","unstructured":"Ryan AM, Rowley SP, Fitzgerald AP, et al. Adenocarcinoma of the oesophagus and gastric cardia: male preponderance in association with obesity. Eur J Cancer. 2006;42(8):1151\u20138.","journal-title":"Eur J Cancer"}],"updated-by":[{"DOI":"10.1007\/s11695-020-04579-0","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2020,4,20]],"date-time":"2020-04-20T00:00:00Z","timestamp":1587340800000}},{"DOI":"10.1007\/s11695-021-05765-4","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2021,11,3]],"date-time":"2021-11-03T00:00:00Z","timestamp":1635897600000}}],"container-title":["Obesity Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11695-020-04485-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11695-020-04485-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11695-020-04485-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,4]],"date-time":"2021-11-04T07:20:11Z","timestamp":1636010411000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11695-020-04485-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,24]]},"references-count":39,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2020,6]]}},"alternative-id":["4485"],"URL":"https:\/\/doi.org\/10.1007\/s11695-020-04485-5","relation":{"correction":[{"id-type":"doi","id":"10.1007\/s11695-020-04579-0","asserted-by":"object"},{"id-type":"doi","id":"10.1007\/s11695-021-05765-4","asserted-by":"object"}]},"ISSN":["0960-8923","1708-0428"],"issn-type":[{"value":"0960-8923","type":"print"},{"value":"1708-0428","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,24]]},"assertion":[{"value":"24 February 2020","order":1,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 April 2020","order":2,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":3,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":4,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1007\/s11695-020-04579-0","URL":"https:\/\/doi.org\/10.1007\/s11695-020-04579-0","order":5,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 November 2021","order":6,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":7,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":8,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1007\/s11695-021-05765-4","URL":"https:\/\/doi.org\/10.1007\/s11695-021-05765-4","order":9,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with Ethical Standards"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}}]}}