title: Sleeve gastrectomy leads to Helicobacter pylori eradication.
abstract: BACKGROUND
  The role of Helicobacter pylori (HP) in patients scheduled and undergoing laparoscopic sleeve gastrectomy (LSG) has not been previously evaluated.
  
  
  METHODS
  Included were obese patients presenting to our institution for LSG over 24 months. All patients had presurgical HP breath test, and the symptomatic ones received triple therapy with symptom follow-up. Post surgery, all excluded stomachs were evaluated for HP, and those that were positive performed a second 13C-urea breath test (UBT) 3 months later.
  
  
  RESULTS
  Forty patients underwent LSG. Male to female sex ratio was 1:3; mean age-42 years; mean weight-122 kg; and mean BMI of 43.4 kg/m2. Presurgical HP was positive in 15 (37.5%) patients (11 symptomatic and four asymptomatic). Only these 11 patients were given HP eradication therapy and all experienced complete subsequent symptom resolution. HP was detected in 17 out of the 40 (42.5%) cases of excluded stomachs. All performed a 13C-UBT 3 months post operation and only three (17.6%) tested positive.
  
  
  CONCLUSIONS
  HP infection is frequent in biopsies from patients with previous LSG and the majority of follow-up 13C-UBT were negative. In our small initial sample, we treated only symptomatic patients preoperatively. Routine screening for HP for all LSG patients and/or treatment for all positive ones would subject patients to expensive and unnecessary investigations. We propose that this stomach-reducing, pylorus-preserving surgery might even lead to HP eradication. The clinical implications of HP and this gastrectomy for a non-neoplastic, non-peptic indication deserve further study.
authors.affiliation: Gastroenterology Unit, Surgery Department, Bnai Zion Medical Center, Technion-Institute of Technology, Haifa, Israel. Dean.keren@b-zion.org.il
authors.forename: Dean
authors.initials: D
authors.lastname: Keren
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Matter
authors.forename: Tova
authors.initials: T
authors.lastname: Rainis
authors.forename: Omer
authors.initials: O
authors.lastname: Goldstein
authors.forename: Edy
authors.initials: E
authors.lastname: Stermer
authors.forename: Alexandra
authors.initials: A
authors.lastname: Lavy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001944:Breath Tests; D002985:Clinical Protocols; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D016481:Helicobacter Infections / Q000175:diagnosis / Q000601:surgery*; D016480:Helicobacter pylori / Q000187:drug effects / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000382:microbiology / Q000601:surgery; D012189:Retrospective Studies; D013270:Stomach / Q000382:microbiology*; D016896:Treatment Outcome; D014508:Urea; D055815:Young Adult
chemical_list: D014508:Urea