Gastroenterologia y hepatologia · 2025
Relevance of endoscopy and Helicobacter pylori infection in the preoperative management of obesity with sleeve gastrectomy.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Fernández Aceñero Mª Jesús, Olmos Rodríguez Lucía, Galindo Fernández Carlos
Аннотация
OBJECTIVES: Obesity has reached pandemic dimensions, representing a large health burden. Conservative therapy has recently been improved, but the most definitive therapy is still surgery. Gastric sleeve is one of the most frequent techniques. Preoperative guidelines sometimes recommend preoperative endoscopy. The aim of this study is to review the preoperative use of endoscopy in bariatric surgery and the possible importance of Helicobacter pylori therapy to avoid surgical complications.
PATIENTS AND METHODS: Retrospective case series of patients undergoing sleeve gastrectomy in two large hospitals. We have reviewed demographic data, associated pathologies, endoscopic findings prior to surgery, histopathological findings in the surgical resection specimen and rate of complications after surgery, as the outcome measure.
RESULTS: 455 patients fulfilled criteria for the study. 69% were women and the mean age was 46.93 (SD: 10.6). 68.7% of the patients show at least one comorbid disease, mainly dyslipidemia, but only 7.2% showed three or more comorbidities. Endoscopy was performed in 41.5% of the patients and biopsy in 35.8%, with significant differences between both hospitals. H. pylori were detected in 53 of the patients undergoing endoscopy and eradicated before surgery. Helicobacter was present in 7% of the surgical resection specimens, 68.75% of whom had not undergone a preoperative endoscopy. The postsurgical complication rate was 23.5% in our series and H. pylori was present in 20% of these patients.
CONCLUSIONS: Our study confirms the relevance of Helicobacter eradication before bariatric surgery, as Helicobacter infection is significantly linked to the surgical outcome in our area.
PATIENTS AND METHODS: Retrospective case series of patients undergoing sleeve gastrectomy in two large hospitals. We have reviewed demographic data, associated pathologies, endoscopic findings prior to surgery, histopathological findings in the surgical resection specimen and rate of complications after surgery, as the outcome measure.
RESULTS: 455 patients fulfilled criteria for the study. 69% were women and the mean age was 46.93 (SD: 10.6). 68.7% of the patients show at least one comorbid disease, mainly dyslipidemia, but only 7.2% showed three or more comorbidities. Endoscopy was performed in 41.5% of the patients and biopsy in 35.8%, with significant differences between both hospitals. H. pylori were detected in 53 of the patients undergoing endoscopy and eradicated before surgery. Helicobacter was present in 7% of the surgical resection specimens, 68.75% of whom had not undergone a preoperative endoscopy. The postsurgical complication rate was 23.5% in our series and H. pylori was present in 20% of these patients.
CONCLUSIONS: Our study confirms the relevance of Helicobacter eradication before bariatric surgery, as Helicobacter infection is significantly linked to the surgical outcome in our area.