The Effect of Helicobacter pylori Eradication on Gastric Wall Thickness in Patients Undergoing Laparoscopic Sleeve Gastrectomy

• Published in: Obesity surgery Vol. 31; no. 9; pp. 4024 - 4032
• Main Authors: Ergin, Anıl, Çiyiltepe, Hüseyin, Karip, Aziz Bora, Fersahoğlu, Mehmet Mahir, Bulut, Nuriye Esen, Çakmak, Ahmet, Topaloğlu, Berk, Bilgili, Ali Cihan, Somay, Adnan, Taşdelen, İksan, Akyüz, Ümit, Memişoğlu, Kemal
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-09-2021; Springer Nature B.V
• Subjects: Bacterial infections; Gastrectomy; Gastric Mucosa; Gastrointestinal surgery; Gram-negative bacteria; Helicobacter Infections - drug therapy; Helicobacter pylori; Humans; Laparoscopy; Medicine; Medicine & Public Health; Obesity; Obesity, Morbid - surgery; Original Contributions; Stomach; Surgery; Surgical outcomes; Helicobacter pylori; Laparoscopic sleeve gastrectomy; Gastric wall thickness
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-021-05513-8

Purpose
The most important cause affecting the thickness of the gastric wall other than the tumor is chronic gastritis caused by
Helicobacter pylori
(Hp), which is most frequently detected in the antrum. This study aims to investigate the effect of bismuth-based treatment (BBT) combined with proton pump inhibitor (PPI) on wall thicknesses measured in the postoperative gastric specimen and early postoperative complications in patients with Hp-positive pre-LSG endoscopic gastric biopsies.
Materials and Methods
The patients who underwent LSG procedure for morbid obesity were divided into three groups as follows: Hp-negative, Hp-positive without eradication treatment, and Hp-positive, and LSG was performed after eradication treatment. Macroscopic and microscopic gastric wall thickness measurements were made at a distance of 1 cm from the proximal surgical margin, from the middle part of the specimen, and 1 cm from the distal surgical margin in the gastric specimen and the results were compared.
Results
A total of 132 patients were included in the study, 44 patients in each group. Microscopically measured antrum mucosal thickness was found to be statistically significantly higher in group 2 compared to other groups (groups 1.15, 1.35, 1.16 mm, respectively, p = 0.000). There was no difference between the groups in terms of early complications such as bleeding, wound site infection, or leakage from the staple line within the first 28 days after surgery.
Conclusion
This study found that LSG had no effect on early complications due to Hp positivity or eradication of Hp.
Key Points
•
The presence of HP increases the wall thickness of the gastric antrum mucosa.
•
After HP eradication, stomach antrum wall thickness returns to normal.
•
HP eradication before LSG reduces the wall thickness of the gastric antrum mucosa.
•
It was determined that HP scanning and eradication before LSG had no effect on postoperative complications.
Graphical abstract