Impact of Helicobacter pylori Status on Postoperative Morbidities After Laparoscopic Sleeve Gastrectomy in an Endemic Region (a Retrospective Multicentric Study)

Obes Surg. 2024 Jan;34(1):183-191. doi: 10.1007/s11695-023-06961-0. Epub 2023 Nov 22.

Abstract

Purpose: Studies are still ongoing to determine whether Helicobacter pylori (HP) may affect the results of laparoscopic sleeve gastrectomy (LSG). The main research objectives were HP prevalence in patients with severe obesity and the effects of HP status on outcomes.

Patients and methods: This multicenter retrospective study included patients with severe obesity who had LSG. The patients were grouped into three groups based on the HP status of preoperative endoscopic biopsies and postoperative specimen results: group I (negative HP), group II (eradicated HP), and group III (positive HP). The primary outcome was the overall postoperative morbidities.

Results: One thousand six hundred fifteen patients who underwent LSG for severe obesity were included in this study. Seven hundred fifty (46.4%) patients had negative HP, and 637 (39.4%) patients had eradicated HP, whereas 228 (14.1%) patients had positive HP. The antral and gastric body wall thickness was significantly noticed with positive HP. The groups had no significant differences regarding postoperative complication frequency, severity, and hospital mortality. The rates of gastric leakage in the three groups do not differ significantly. BMI > 50, gastropexy, gastric thickness, and antral resection were found to be independent risk factors for the occurrence of postoperative complications after LSG. There was no statistical significance as regards postoperative %TWL and %EWL among the three groups.

Conclusion: The early results of LSG do not appear to be impacted by HP's status. The early postoperative course is unaffected by HP eradication anymore. Therefore, routine preoperative HP testing may not be as necessary, and management can be finished after LSG.

Keywords: Gastric leakage; Gastropexy; Helicobacter pylori; Severe obesity; Sleeve gastrectomy.

Publication types

  • Multicenter Study

MeSH terms

  • Gastrectomy / adverse effects
  • Gastrectomy / methods
  • Helicobacter pylori*
  • Humans
  • Laparoscopy* / methods
  • Obesity / surgery
  • Obesity, Morbid* / surgery
  • Postoperative Complications / etiology
  • Prevalence
  • Retrospective Studies
  • Treatment Outcome