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Short\u2010term, the surgery can cause complications like bleeding, leaks, and fistulas, and longer\u2010term problems such as intestinal or biliary anastomotic strictures or biliary stones can arise, all necessitating endoscopy. In addition, the usual upper gastrointestinal pathologies can also still occur. These patients pose unique challenges. To proceed, understanding the new layout of the upper gastrointestinal tract is essential. The endoscopist, armed with a clear plan for navigation, can readily diagnose and manage most commonly occurring conditions, such as marginal ulcers and proximal anastomotic strictures with standard endoscopic instruments. With complex reconstructions involving long segments of small bowel, such as Roux\u2010en\u2010Y gastric bypass, utilization of balloon\u2010assisted enteroscopy may be necessary, mandating modification of procedures such as endoscopic retrograde cholangiopancreatography. Successful endoscopic management of patients with altered anatomy will require prior planning and preparation to ensure the appropriate equipment, setting, and skill set is provided.<\/jats:p>","DOI":"10.1111\/den.14823","type":"journal-article","created":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T06:53:58Z","timestamp":1719903238000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Upper gastrointestinal endoscopy in the surgically altered patient"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2980-0584","authenticated-orcid":false,"given":"Purnima","family":"Bhat","sequence":"first","affiliation":[{"name":"Gastroenterology and Hepatology Unit Canberra Hospital  Canberra Australia"},{"name":"College of Health and Medicine Australian National University  Canberra Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur John","family":"Kaffes","sequence":"additional","affiliation":[{"name":"Interventional Endoscopy Chris O'Brien Lifehouse  Sydney Australia"},{"name":"AW Morrow Gastroenterology and Liver Centre Royal Prince Alfred Hospital  Sydney Australia"},{"name":"Department of Medicine University of Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristoffer","family":"Lassen","sequence":"additional","affiliation":[{"name":"Department of HPB Surgery Oslo University Hospital  Oslo Norway"},{"name":"Institute of Clinical Medicine UiT The Arctic University of Norway  Troms\u00f8 Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Aabakken","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine University of Oslo  Oslo Norway"},{"name":"Department of Transplantation Medicine Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-017-2666-x"},{"key":"e_1_2_8_3_1","unstructured":"Centres for Disease Control and Prevention.Overweight and obesity [Internet].2023[cited 2023 Dec 12]. 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