Helicobacter pylori Does not Affect Postoperative Outcomes After Sleeve Gastrectomy

Shanti, Hiba; Almajali, Neyaf; Al-Shamaileh, Tamador; Samarah, Walid; Mismar, Ayman; Obeidat, Firas

doi:10.1007/s11695-016-2470-z

Cited by 32 publications

(15 citation statements)

References 18 publications

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“…The postoperative complication rate was 11.2% but with no correlation between preoperative endoscopy results and complications . The same results were obtained in a cohort of patients undergoing sleeve gastrectomy who had complications (leaking, bleeding, or vomiting) in 2.6% without any relation to H. pylori infection . Probably the best solution is to perform a noninvasive test to detect H. pylori infection before bariatric surgery.…”

Section: Bariatric Surgerysupporting

confidence: 51%

“…37 The same results were obtained in a cohort of patients undergoing sleeve gastrectomy who had complications (leaking, bleeding, or vomiting) in 2.6% without any relation to H. pylori infection. 38 Probably the best solution is to perform a noninvasive test to detect H. pylori infection before bariatric surgery. H. pylori eradication is providing symptom relief in a relatively small subgroup of patients with FD; however, the quality of life may not benefit significantly in this subgroup.…”

Section: Bariatric Surgerymentioning

confidence: 99%

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Helicobacter pylori infection and nonmalignant diseases

et al. 2017

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A substantial decrease in Helicobacter pylori-associated peptic ulcer disease has been observed during the last decades. Drug-related ulcers as well as idiopathic ulcers are becoming predominant and are more refractory to treatment; however, H. pylori infection still plays an important role in ulcer bleeding and recurrence after therapy. The effect of H. pylori eradication upon functional dyspepsia symptoms has been reviewed in this article and generally confirms the results of previous meta-analyses. Additional evidence suggests a lack of impact upon the quality of life, in spite of improvement in symptoms. The association of H. pylori with gastroesophageal reflux disease and Barrett's esophagus remains controversial with a majority of published studies showing a negative association. Furthermore, a strong inverse relationship between the presence of H. pylori and the esophageal eosinophilia was also reported. Several studies and a review addressed the role of H. pylori in autoimmune gastritis and pernicious anemia. The association of the above still remains controversial. Finally, the necessity of routine endoscopy and H. pylori eradication before bariatric surgery is discussed. Several studies suggest the rationale of preoperative upper endoscopy and H. pylori eradication prior to surgery. However, the prevalence of H. pylori infection prior to surgery in these studies generally reflects the overall prevalence of the infection in the particular geographic area. In addition, results on the role of H. pylori in developing postoperative complications remain controversial.

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Section: Bariatric Surgerysupporting

confidence: 51%

Section: Bariatric Surgerymentioning

confidence: 99%

Helicobacter pylori infection and nonmalignant diseases

et al. 2017

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“…Moreover, colonization with Helicobacter pylori may be associated with a more frequent occurrence of postoperative symptoms from the large intestine, most often abdominal pain, nausea, and vomiting [9]. However, the results of some studies are inconclusive on this matter, suggesting that colonization with Helicobacter pylori is not related to the incidence of early postoperative complications and, hence, preoperative EGD may not be necessary [10]. Furthermore, the results of some studies seem to support selective EGD, solely in patients presenting with gastroesophageal ailments [11].…”

Section: Introductionmentioning

confidence: 99%

Role of Preoperative Esophagogastroduodenoscopy (EGD) in Bariatric Treatment

Sierżantowicz

Ładny

Kurek

et al. 2021

JCM

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Background: The recommendations for routine preoperative esophagogastroduodenoscopy (EGD) in patients qualified for bariatric surgeries are still a matter of debate. The aim of this study was to analyze the pathologies on preoperative EGD in patients qualified for bariatric surgeries. Materials and Methods: This study included 222 patients, divided into two groups. The obesity group consisted of patients with obesity (BMI ≥ 40 kg/m2), for whom EGD was a routine part of the preparation for laparoscopic sleeve gastrectomy (LSG). The control group of patients with normal body weight (BMI) qualified for EGD because of gastrointestinal ailments. Results: Regarding preoperative EGD in patients qualified for bariatric surgeries, we analyzed the prevalence of endoscopic pathologies in various gastrointestinal tract segments. Patients with obesity were shown to present with esophageal pathologies significantly more often than persons in the control group (n = 23, 20.91% vs. n = 12, 10.91%, p = 0.042). The odds ratio of esophageal pathologies in patients with obesity versus the control group equaled 2.15 (95%CI: 1.01–4.59). In turn, the odds ratio of duodenal pathologies in patients from the control group was 3.31 (95%Cl: 1.16–9.47), which means that persons from this group were approximately three times more likely to be diagnosed with those pathologies compared to obese patients. Moreover, patient sex was a significant predictor of duodenal pathologies, with an odds ratio of 4.03 (95%CI: 1.53–10.61). Conclusions: Preoperative EGD can identify a broad spectrum of pathologies in obese patients, which suggests a routine examination before bariatric surgery.

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We fully understand your concerns and agree that Helicobacter pylori (HP) is a well-established risk factor for gastric cancer, and it is implicated in the pathogenesis of various benign and malignant diseases.

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confidence: 99%

“…We thank Dr. Kassir and his colleagues for their attention to our manuscript entitled: Helicobacter pylori does not affect postoperative outcomes after sleeve gastrectomy [1].…”

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confidence: 99%

Reply to the Letter to the Editor on “Helicobacter Pylori Does Not Affect Postoperative Outcomes after Sleeve Gastrectomy”

et al. 2017

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We thank Dr. Kassir and his colleagues for their attention to our manuscript entitled: Helicobacter pylori does not affect postoperative outcomes after sleeve gastrectomy [1].First, we would like to focus that our study included patients undergoing sleeve gastrectomy (LSG) and not gastric bypass. Hence, the stomach is easily accessible for endoscopic surveillance postoperatively.We fully understand your concerns and agree that Helicobacter pylori (HP) is a well-established risk factor for gastric cancer, and it is implicated in the pathogenesis of various benign and malignant diseases. Our article discussed the timing of treatment and is not against HP eradication. This issue was evident by treating all HP-positive patients in our study two weeks postoperatively.Some papers cited in our article suggested that HP should be eradicated before surgery as it might increase the incidence of leak. However, our article showed that preoperative surveillance might not be necessary as HP infection did not affect the rate of early postoperative complications. Therefore, eradication therapy can be given postoperatively based on histopathological examination of excised stomach, which is more accurate than other methods of testing.Worth mentioning that Keren et al. [2] showed that LSG might lead to HP eradication, due to the resection of the usual sites of bacterial infection. This might suggest repeat testing for HP three months postoperatively before giving eradication therapy.With regard to GERD and Barret esophagus (BE) post sleeve gastrectomy, studies had shown controversial results. Technical considerations might be implicated in the incidence of GERD postoperatively. Data from the literature concerning the development of BE after LSG are scarce. Genco et al. [3] showed a very high incidence of BE in LSG patients. Thus, endoscopic evaluation in the postoperative surveillance of LSG patients should be encouraged.

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Helicobacter pylori Does not Affect Postoperative Outcomes After Sleeve Gastrectomy

Abstract: There is no clear association between HP infection at the time of surgery and postoperative complications, especially leaks.

Cited by 32 publications

References 18 publications

Helicobacter pylori infection and nonmalignant diseases

Helicobacter pylori infection and nonmalignant diseases

Role of Preoperative Esophagogastroduodenoscopy (EGD) in Bariatric Treatment

Reply to the Letter to the Editor on “Helicobacter Pylori Does Not Affect Postoperative Outcomes after Sleeve Gastrectomy”

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