Estudos endoscópico e histológico prospectivos e sequenciais da bolsa gástrica em 130 pacientes obesos mórbidos submetidos à bypass gástrico em Y-de-Roux
Abstract:-Background -Roux-en-Y gastric bypass is the most common performed bariatric surgery. A small gastric pouch is created, leaving a narrow gastrojejunal anastomosis, with a long jejunal limb. Very little is known regarding the behavior of this pouch years after surgery. Aim -To determine through prospective sequential endoscopic studies the size of the gastric pouch, the diameter of the anastomosis, and the behavior of H. pylori infection after surgery. Methods -In 130 patients subjected to resectional gastric b… Show more
“…Other authors, analyzing the gastric pouch and the presence of HP, have found no association between the presence of HP and the gastric pouch or gastrojejunal anastomosis size. These authors concluded that the behavior of HP is inconsistent and difficult to interpret 9 .…”
Background:Morbid obesity is a multifactorial disease that increasingly is being treated by
surgery. Aim: To evaluate gastric histopathological changes in obese, and to compare with
patients who underwent gastrojejunal bypass and the jejunal mucosa after the
surgery. Methods:This is an observational study performed at a tertiary public hospital, evaluating
endoscopic biopsies from 36 preoperative patients and 35 postoperative. Results:In the preoperative group, 80.6% had chronic gastritis, which was active in 38.9%
(77.1% and 20.1%, respectively, in the postoperative). The postoperative group had
a significant reduction in H. pylori infection (p=0.0001). A longer length of the
gastric stump and a time since surgery of more than two years were associated with
Helicobacter pylori infection. The jejunal mucosa was normal in 91.4% and showed
slight nonspecific chronic inflammation in 8.6%. Conclusion:There was a reduction in the incidence of Helicobacter pylori infection in the
postoperative group. A longer length of the gastric stump and longer time elapsed
since surgery were associated with Helicobacter pylori infection. The jejunal
mucosa was considered normal in an absolute majority of patients.
“…Other authors, analyzing the gastric pouch and the presence of HP, have found no association between the presence of HP and the gastric pouch or gastrojejunal anastomosis size. These authors concluded that the behavior of HP is inconsistent and difficult to interpret 9 .…”
Background:Morbid obesity is a multifactorial disease that increasingly is being treated by
surgery. Aim: To evaluate gastric histopathological changes in obese, and to compare with
patients who underwent gastrojejunal bypass and the jejunal mucosa after the
surgery. Methods:This is an observational study performed at a tertiary public hospital, evaluating
endoscopic biopsies from 36 preoperative patients and 35 postoperative. Results:In the preoperative group, 80.6% had chronic gastritis, which was active in 38.9%
(77.1% and 20.1%, respectively, in the postoperative). The postoperative group had
a significant reduction in H. pylori infection (p=0.0001). A longer length of the
gastric stump and a time since surgery of more than two years were associated with
Helicobacter pylori infection. The jejunal mucosa was normal in 91.4% and showed
slight nonspecific chronic inflammation in 8.6%. Conclusion:There was a reduction in the incidence of Helicobacter pylori infection in the
postoperative group. A longer length of the gastric stump and longer time elapsed
since surgery were associated with Helicobacter pylori infection. The jejunal
mucosa was considered normal in an absolute majority of patients.
“…After pouch creation, the mucosa remains normal where parietal cells are plentiful and the pouch does not dilate. 14,15 Because the pouch contains a small amount of gastric corpus, the total amount of acid secreted is small. 16,17 However, because parietal cells secrete approximately 150 mmol/L HCl (pH, ~0.8), the intrapouch pH is generally low.…”
Section: The Gastric Pouch and Acid Secretionmentioning
H. pylori is an independent predictor of marginal ulceration using a large national database. Preoperative testing for and eradication of H. pylori prior to bariatric surgery may be an important preventive measure to reduce the incidence of ulcer development.
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