Does Helicobacter pylori Infection Affect Postoperative Outcomes after Bariatric Surgery?
Abstract
Objective: The impact of Helicobacter pylori (HP) infection on postoperative outcomes remains controversial. This study aimed to investigate the relationship between HP infection and postoperative outcomes, including the percentage of postoperative excessive weight loss (%EWL) at 3, 6, and 12 months and post-surgical complications.
Material and Methods: This study involved a retrospective cohort study of 173 patients who underwent weight loss surgery at Thammasat University Hospital, Thailand, between 2015 and 2023. Participants met the indications for bariatric surgery and were preoperatively screened for HP infection.
Results: The majority of the participants were female (77.3%). The mean age and preoperative BMI were 35.3±8.1 years old and 44.2±9.4 kg/m2 respectively. Seventy-five patients (43.3%) tested positive for HP infection. Baseline characteristics were similar between the HP-positive and non-HP groups. The %EWL of the HP-positive group at 3, 6 and 12 months was 42.72, 62 and 74, respectively. For the non-HP group, the %EWL at 3, 6 and 12 months was 36, 57 and 70.5, respectively. No statistically significant difference of %EWL was observed between the 2 groups. Postoperative adverse effects were reported with no statistically significant difference between the groups. In the HP-positive group, complications were observed in 5 patients (6.7%), whereas in the non-HP group 7 patients (7.14%) had complications.
Conclusion: HP infection did not influence postoperative weight loss outcomes or complications after bariatric surgery.
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FitzGerald R, Smith SM. An Overview of Helicobacter pylori Infection. Methods Mol Biol 2021;2283:1-14.
De Brito BB, Da Silva FAF, Soares AS, Pereira VA, Santos MLC, Sampaio MM, et al. Pathogenesis and clinical management of Helicobacter pylori gastric infection. World J Gastroenterol 2019;25:5578-89.
Chen YC, Malfertheiner P, Yu HT, Kuo CL, Chang YY, Meng FT, et al. Global prevalence of Helicobacter pylori Infection and Incidence of gastric cancer between 1980 and 2022. Gastroenterology 2024;166:605-19.
Uchida T, Miftahussurur M, Pittayanon R, Vilaichone RK, Wisedopas N, Ratanachu-Ek T, et al. Helicobacter pylori infection in Thailand: a nationwide study of the CagA Phenotype. PLoS One 2015;10.
Aumpan N, Vilaichone RK, Nunanan P, Chonprasertsuk S, Siramolpiwat S, Bhanthumkomol P, et al. Predictors for development of complete and incomplete intestinal metaplasia (IM) associated with H. pylori infection: a large-scale study from low prevalence area of gastric cancer (IM-HP trial). PLoS One 2020;1;15.
Carabotti M, D’Ercole C, Iossa A, Corazziari E, Silecchia G, Severi C. Helicobacter pylori infection in obesity and its clinical outcome after bariatric surgery. World J Gastroenterol 2014;21:647-53.
Osawa H, Nakazato M, Date Y, Kita H, Ohnishi H, Ueno H, et al. Impaired production of gastric ghrelin in chronic gastritis associated with Helicobacter pylori. J Clin Endocrinol Metab 2005;90:10-6.
Isomoto H, Nakazato M, Ueno H, Date Y, Nishi Y, Mukae H, et al. Low plasma ghrelin levels in patients with Helicobacter pylori-associated gastritis. Am J Med 2004;117:429-32.
Nweneka CV, Prentice AM. Helicobacter pylori infection and circulating ghrelin levels - a systematic review. BMC Gastroenterol 2011;11:7.
Nwokolo CU, Freshwater DA, O’Hare P, Randeva HS. Plasma ghrelin following cure of Helicobacter pylori. Gut 2003;52:637-40.
Maksud FA, Alves JS, Diniz MT, Barbosa AJ. Density of ghrelin-producing cells is higher in the gastric mucosa of morbidly obese patients. Eur J Endocrinol 2011;165:57-62.
Erim T, Cruz-Correa MR, Szomstein S, Velis E, Rosenthal R. Prevalence of Helicobacter pylori seropositivity among patients undergoing bariatric surgery: a preliminary study. World J Surg 2008;32:2021-5.
Arslan E, Atilgan H, Yavaşoğlu I. The prevalence of Helicobacter pylori in obese subjects. Eur J Intern Med 2009;20:695-7.
Rasmussen JJ, Fuller W, Ali MR. Marginal ulceration after laparoscopic gastric bypass: an analysis of predisposing factors in 260 patients. Surg Endosc 2007;21:1090-4.
Schulman AR, Abougergi MS, Thompson CC. H. Pylori as a predictor of marginal ulceration: a nationwide analysis. Obesity (Silver Spring) 2017;25:522-6.
Mocanu V, Dang JT, Switzer N, Skubleny D, Shi X, de Gara C, et al. The effect of Helicobacter pylori on postoperative outcomes in patients undergoing bariatric surgery: a systematic review and meta-analysis. Obes Surg 2018;28:567-73.
Marcolin P, Machado Berleze M, Polettini J, Marchesan Rodrigues MA, Augustin Silveira D. The impact of Helicobacter pylori on laparoscopic sleeve gastrectomy postoperative complications: a systematic review and meta-analysis. Obes Surg 2023;33:3649-57.
Beran A, Shaear M, Al-Mudares S, Sharma I, Matar R, Al-Haddad M, et al. Predictors of marginal ulcer after gastric bypass: a systematic review and meta-analysis. J Gastrointest Surg 2023;27:1066-77.
Papasavas PK, Gagné DJ, Donnelly PE, Salgado J, Urbandt JE, Burton KK, et al. Prevalence of Helicobacter pylori infection and value of preoperative testing and treatment in patients undergoing laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis 2008;4:383-8.
Rawlins L, Rawlins MP, Brown CC, Schumacher DL. Effect of Helicobacter pylori on marginal ulcer and stomal stenosis after Roux-en-Y gastric bypass. Surg Obes Relat Dis 2013;9:760-4.
Brownlee AR, Bromberg E, Roslin MS. Outcomes in patients with Helicobacter pylori undergoing laparoscopic sleeve gastrectomy. Obes Surg 2015;25:2276-9.
Rossetti G, Moccia F, Marra T, Buonomo M, Pascotto B, Pezzullo A, et al. Does helicobacter pylori infection have influence on outcome of laparoscopic sleeve gastrectomy for morbid obesity? Int J Surg 2014;12(Suppl 1):S68-71. doi: 10.1016/j.ijsu.2014.05.051.
Gonzalez-Heredia R, Tirado V, Patel N, Masrur M, Murphey M, Elli E. Is Helicobacter Pylori Associated with an Increased complication rate after sleeve gastrectomy? Bariatr Surg Pract Patient Care 2015;10:15-8.
Shanti H, Almajali N, Al-Shamaileh T, Samarah W, Mismar A, Obeidat F. Helicobacter pylori does not affect postoperative outcomes after sleeve gastrectomy. Obes Surg 2017;27:1298-1301.
Park YS, Ahn K, Yun K, Jeong J, Baek KW, Park DJ, et al. Effect of Helicobacter pylori on sleeve gastrectomy and gastric microbiome differences in patients with obesity and diabetes. Int J Obes (Lond) 2024:48;1664-72.
Farazmand B, Shahsavan M, Eghbali F, Pazouki A, Kermansaravi M. Comparison of weight loss after Roux-en-Y gastric bypass in Helicobacter pylori-negative and Helicobacter pylori eradicated patients during five years follow-ups. Surg Endosc 2024;38:888-93.
Wang HH, Lee WJ, Liew PL, Yang CS, Liang RJ, Wang W, et al. The influence of Helicobacter pylori infection and corpus gastritis on the postoperative outcomes of laparoscopic vertical banded gastroplasty. Obes Surg 2006;16:297-307.
Chanda D, De D. Meta-analysis reveals obesity associated gut microbial alteration patterns and reproducible contributors of functional shift. Gut Microbes 2024;16:2304900.
Chen CC, Liou JM, Lee YC, Hong TC, El-Omar EM, Wu MS. The interplay between Helicobacter pylori and gastrointestinal microbiota. Gut Microbes 2021;13:1-22.
Lane JA, Murray LJ, Harvey IM, Donovan JL, Nair P, Harvey RF. Randomised clinical trial: Helicobacter pylori eradication is associated with a significantly increased body mass index in a placebo-controlled study. Aliment Pharmacol Ther 2011;33:922-9.
Fujiwara Y, Higuchi K, Arafa UA, Uchida T, Tominaga K, Watanabe T, et al. Long-term effect of Helicobacter pylori eradication on quality of life, body mass index, and newly developed diseases in Japanese patients with peptic ulcer disease. Hepatogastroenterology 2002;49:1298-302.
Kamada T, Hata J, Kusunoki H, Ito M, Tanaka S, Kawamura Y, et al. Eradication of Helicobacter pylori increases the incidence of hyperlipidaemia and obesity in peptic ulcer patients. Dig Liver Dis 2005;37:39-43.
Alavinejad P, Hajiani E, Parsi A, Satari A, Rezaei MJ, Nayebi M, et al. Effect of Helicobacter pylori eradication on metabolic profile: an international, multicenter, case-control study. BMC Gastroenterol 2022;22:507.
Kim JW, Baeg MK, Bang CS, Park JK, Oh JH; the Diet, Obesity, and Metabolism Research Study Group of the Korean Society of Neurogastroenterology and Motility. Effect of Helicobacter pylori eradication on body weight: a multicenter propensity score-matched analysis in Korea. J Neurogastroenterol Motil 2023;29:352-9.
Goday A, Castañer O, Benaiges D, Pou AB, Ramón JM, Iglesias MDM, et al. Can Helicobacter pylori eradication treatment modify the metabolic response to bariatric surgery? Obes Surg 2018;28:2386-95.
Watari J, Chen N, Amenta PS, Fukui H, Oshima T, Tomita T, et al. Helicobacter pylori associated chronic gastritis, clinical syndromes, precancerous lesions, and pathogenesis of gastric cancer development. World J Gastroenterol 2014;20:5461-73.
Lee YC, Chiang TH, Chou CK, Tu YK, Liao WC, Wu MS, et al. Association between Helicobacter pylori eradication and gastric cancer incidence: a systematic review and meta-analysis. Gastroenterology 2016;150:1113-24.
Ford AC, Yuan Y, Forman D, Hunt R, Moayyedi P. Helicobacter pylori eradication for the prevention of gastric neoplasia. Cochrane Database Syst Rev 2020;7:CD005583.
Doukas SG, Doukas PG, Vageli DP, Broder A. Gastric cancer after bariatric bypass surgery. Do they relate? (a systematic review). Obes Surg 2023;33:1876-88.
Mechanick JI, Apovian C, Brethauer S, Garvey WT, Joffe AM, Kim J, et al. Clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures – 2019 update: cosponsored By American association of clinical endocrinologists/american college of endocrinology, the obesity society, American society for metabolic & bariatric surgery, obesity medicine association, and American society of anesthesiologists – executive summary. Endocr Pract 2019;25:1346-59.
Glazer S, Biertho L. Canadian adult obesity clinical practice guidelines: bariatric surgery: selection & pre-operative workup [homepage on the Internet]. Edmonton: Obesity Canada; [cited 2024 Jul 3]. Available from: https://obesitycanada.ca/guidelines/preop
Techagumpuch, A, Pantanakul S, Chansaenroj P, Boonyagard N, Wittayapairoch J, Poonthananiwatkul T, et al. Thai society for metabolic and bariatric surgery consensus guideline on bariatric surgery for the treatment of obese patient in Thailand. J Med Assoc Thai 2020;103:300-7.
Di Lorenzo N, Antoniou SA, Batterham RL, Busetto L, Godoroja D, Iossa A, et al. Clinical practice guidelines of the European Association for Endoscopic Surgery (EAES) on bariatric surgery: update 2020 endorsed by IFSO-EC, EASO and ESPCOP. Surg Endosc 2020;34:2332-58.
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