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Helicobacter pylori, Sleeve Gastrectomy, and Gastroesophageal Reflux Disease; Is there a Relation?

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Abstract

Purpose

Sleeve gastrectomy (SG) is an effective bariatric procedure, yet can be associated with complications as gastroesophageal reflux disease (GERD). The present study aimed to investigate the prevalence of Helicobacter pylori (H. pylori) in SG specimens, its relation with GERD, and its impact on postoperative outcomes.

Methods

All SG specimens received in the pathology laboratory were reviewed. The prevalence of H. pylori in SG specimens was recorded. Patients with H. pylori infection who received triple therapy were compared with patients without H pylori in terms of baseline characteristics, preoperative GERD and its outcome postoperatively, development of new-onset GERD, staple line complications, and weight loss.

Results

The records of 176 patients were reviewed; 69 (39.2%) were positively tested on H. pylori infection. Patients with H. pylori had higher body mass index (BMI) (RR = 1.51), greater incidence of preoperative GERD (RR = 1.67), and complained more of dyspepsia (RR = 1.87). Eradication of H. pylori was achieved in 67 (97.1%) of 69 patients. Postoperative improvement in GERD symptoms (44.4% Vs 19%, p = 0.036) and dyspepsia (85.7% Vs 51.7%, p = 0.007) was higher in patients with H. pylori with confirmed eradication of infection than patients without H. pylori. Both groups had similar operation time, postoperative BMI, excess weight loss, staple line complications, and new-onset GERD.

Conclusions

More than one-third of patients with morbid obesity had H. pylori infection. Morbidly obese patients with H. pylori infection may be more prone to develop GERD symptoms; yet after eradication of the infection, they may also experience better improvement in symptoms after SG.

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Authors and Affiliations

  1. General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt

    Sameh H. Emile, Ayman Elshobaky, Hosam G. Elbanna & Mohamed A. Abdel-Razik

  2. Pathology Department, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt

    Wagdi Elkashef

Authors
  1. Sameh H. Emile
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  2. Ayman Elshobaky
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  3. Hosam G. Elbanna
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  4. Wagdi Elkashef
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  5. Mohamed A. Abdel-Razik
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Contributions

Sameh Emile designed the study. Sameh Emile and Mohamed Abdel-Razik contributed to data collection and analysis and writing and revising the manuscript. Ayman Elshobaky contributed to data interpretation, writing, and critical revision of the manuscript. Wagdi Elkashef collected the microscopic images of H. pylori affection, interpreted the results, and revised the manuscript. Hosam Elbanna contributed to data analysis and revision of the manuscript.

Corresponding author

Correspondence to Sameh H. Emile.

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The authors declare that they have no conflict of interest.

Ethical Approval Statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Ethical approval for the study was obtained from the Institutional Review Board (IRB) of our institution.

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Informed consent does not apply as for this type of study formal consent is not required.

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Emile, S.H., Elshobaky, A., Elbanna, H.G. et al. Helicobacter pylori, Sleeve Gastrectomy, and Gastroesophageal Reflux Disease; Is there a Relation?. OBES SURG 30, 3037–3045 (2020). https://doi.org/10.1007/s11695-020-04648-4

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  • DOI: https://doi.org/10.1007/s11695-020-04648-4

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