Development of Guidelines for Diagnostic Procedures in Identifying Latent Liver Failure and Asymptomatic Gastrointestinal Malignancies before Bariatric Surgery

Abstract

Background: Recent advances in bariatric surgery have necessitated the need for careful preoperative assessment of comorbidities. Latent liver failure and gastrointestinal malignancies can cause serious complications in this group of patients. The aim of this study was to investigate and obtain diagnostic guidelines for the identification, diagnosis, and management of latent liver failure and asymptomatic gastrointestinal malignancies in patients who are candidates for bariatric surgery. Methods: This qualitative study was conducted by gathering the opinions of specialists in the field of gastrointestinal and liver diseases through telephone and face-to-face interviews. Active specialists in this field were identified, and their opinions on the diagnosis and management of these diseases were collected. Data were analyzed to identify patterns and extract key points. Findings: The findings showed that most specialists emphasize the need for comprehensive tests, including liver function tests and imaging studies, before surgery. Also, the need for specific protocols for identifying gastrointestinal malignancies and for patients with a history of inflammatory bowel disease (IBD) was identified. Finally, a localized guideline for the diagnosis and management of these conditions was proposed. Conclusion: Developing appropriate guidelines for the identification of latent liver failure and gastrointestinal malignancies in patients undergoing bariatric surgery can help reduce surgical complications and improve patient outcomes. It is recommended that specialists and medical centers pay attention to this guideline and be diligent in implementing it in order to improve the quality of services. © 2026, Isfahan University of Medical Sciences(IUMS). All rights reserved.