The majority of gastric histopathology results after LSG in this study had an element of chronic gastritis (74.4 %), which is in keeping with previous studies showing its high prevalence among the obese population. However, a few cases had clinically significant pathologies, and this may alter post-operative management. In view of these results, routine histological examination of the gastric specimens is highly recommended.
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 comorbid conditions. This study aims to observe the prevalence of H. pylori infection in patients undergoing laparoscopic sleeve gastrectomy (LSG) and its correlation with postoperative complications. A retrospective study was done on the gastric pathology specimen results of 682 patients who underwent LSG at Amiri Hospital from 2008 to 2012. Symptomatic patients had preoperative upper gastrointestinal endoscopies (UGIEs) based on the decision of the treating surgeon, along with campylobacter-like organism test (CLO test) for H. pylori detection. The intraoperatively excised gastric specimen was sent for histopathological assessment of H. pylori, and the patients were followed up for complications. Of the 682 patients, 629 (92.2 %) were found to be H. pylori negative intraoperatively, while 53 (7.8 %) were positive. A total of 32 (4.7 %) patients were found to have postoperative complications, of which 2 (6.3 %) had H. pylori intraoperatively. 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. There appears to be no association between H. pylori infection and post-LSG complications.
Following our algorithm, revising an LSG with an LRSG or LRYGB for poor weight loss is feasible with good outcomes. Larger and longer follow-up studies are needed to verify our results.
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