The Impact of Helicobacter Pylori on the Complications of Laparoscopic Sleeve Gastrectomy

Sulaiman Almazeedi, MD, Salman Al-Sabah, Dheidan Alshammari, Shamlan Alqinai. Amiri Hospital – Kuwait.

Background: Helicobacter Pylori (H. Pylori) is a very common bacterium present in the gastric tissue of up to 50% of people and the mucosal damage it causes can predispose to multiple co-morbid conditions. This study aims to observe the prevalence of H. Pylori infection in patients undergoing laparoscopic sleeve gastrectomy (LSG) and its correlation with post-operative complications.

Methods: A retrospective study was done of the gastric pathology specimen results of 682 patients who underwent LSG at Amiri Hospital from 2008 to 2012. Symptomatic patients had pre-operative upper gastro-intestinal endoscopies (UGIE) based on the decision of the treating surgeon, along with campylobacter-like organism test (CLO-test) for H. Pylori detection. The intra-operative excised gastric specimen was sent for histopathological assessment of H. Pylori and the patients were followed up for complications.

Results: Of the 682 patients, 629 (92.2%) were found to be H. Pylori negative intra-operatively, while 53 (7.8%) were positive. A total of 32 (4.7%) patients were found to have post-operative complications, of which 2 (6.3%) had H. Pylori intra-operatively. No statistical significance (p=0.71), however, was seen between the overall complication rate and H. Pylori. Specifically, there were five (0.7%) cases of leak and eight (1.2%) cases of neuropathy, both of which were not significantly associated with H. Pylori (p=0.33 and p=0.12 respectively). All the other complications had no evidence of H. Pylori.

Conclusions: There appears to be no association between H. Pylori infection and post-LSG complications. Further studies with larger sample sizes are warranted, however, to fully address this issue.

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