Is Helicobacter Pylori associated with a higher risk complication rate in sleeve gastrectomy?

Raquel Gonzalez-Heredia, MD, PhD, Veronica Tirado, MD, Neil Patel, BS, Mario Masrur, MD, Melissa Murphey, DNP, NP-C, Enrique F Elli, MD, FACS. UIC

Introduction:

Few studies have reported the prevalence and consequences of infection with Helicobacter Pylori (H. pylori) among obese patients undergoing sleeve gastrectomy. It is important to determine if H. pylori infection could increase complications or influence outcomes. This study reviewed whether infection with H. pylori based on the microscopic identification within the gastric specimen has any association with post-operative leaks. Secondarily, this study also examined whether there was any difference in outcome related to post-operative % Excess Weight Loss (%EWL).

Material and Methods:

In this retrospective study, we reviewed the pathology reports of 400 patients who underwent sleeve gastrectomy between 2008 and 2013 at our institution. Data examined also included the preoperative body mass index (BMI), comorbidities, operative time, length of stay at hospital, perioperative and post-operative complications and %EWL in the follow-up period.

Results:

All 400 patients underwent a minimally invasive sleeve gastrectomy (SG). In 68 of 400 patients (17%), H. pylori was positive in the specimen. In the H.pylori positive group, 68 patients were eligible for follow-up; and 27, 22, 11, 15 and 2 patients were seen at 6 months, 1 year, 2 years, 3 years and > 3 years follow-up, respectively. In the H.pylori negative group, 341 patients were eligible for follow-up; and 153, 97, 40, 12 and 19 patients were seen at 6 months, 1 year, 2 years, 3 years and > 3 years follow-up, respectively. No perioperative and post-operative (30 days) complications were registered in the H. pylori positive group. There was one post-operative leak which required an intervention in the H. pylori negative group. No others complications were reported in patients during the 36 months of follow-up. There were no significant differences comparing both groups regarding %EWL at 6, 12, 24, 36 and >36 months follow-up.

Conclusions:

In our study, the prevalence of H. pylori infection among sleeve gastrectomy patient was 17%. In this small subset of patients with postoperative leaks, the gastric specimens were negative for H. pylori. In addition, H.pylori did not seem to have an influence on post-operative outcomes such as %EWL.