title: Outcomes in Patients with Helicobacter pylori Undergoing Laparoscopic Sleeve Gastrectomy.
abstract: BACKGROUND
  In vertical sleeve gastrectomy (VSG), the majority of the stomach is resected and much of the tissue colonized with Helicobacter pylori and the bulk of acid producing cells are removed. In addition, the effect of H. pylori colonization of the stomach of patients undergoing stapling procedures is unclear. As a result, the need for detection and treatment of H. pylori in patients undergoing VSG is unknown.
  
  
  METHODS
  Four hundred and eighty patients undergoing VSG are the subject of this study. Three surgeons at a single institution performed the procedures. The remnant stomach was sent to pathology and tested for the presence of H. pylori using immunohistochemistry. All patients were discharged on proton pump inhibitors.
  
  
  RESULTS
  Of the 480 patients who underwent VSG, 52 were found to be H. pylori positive based on pathology. There was no statistically significant difference in age (p = 0.77), sex (p = 0.48), or BMI (p = 0.39) between the groups. There were 17 readmissions post-op. Five of these were in the H. pylori positive cohort. Six of these complications were classified as severe (anastomotic leak, intra-abdominal collection, or abscess), with two in the H. pylori positive cohort (Table 1). There was no statistically significant difference in the severe complication rates between the two groups (p = 0.67). There were no readmissions for gastric or duodenal ulceration or perforation.
  
  
  CONCLUSIONS
  Our data suggests that there is no increase in early complications in patients with H. pylori undergoing VSG. If these findings are confirmed in a long-term follow-up, it would mean that preoperative H. pylori screening in patients scheduled for VSG is not necessary.
authors.affiliation: Department of Surgery, Lenox Hill Hospital, 100 East 77th Street, New York, NY, 10075, USA. brownleeandrew@gmail.com.
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Brownlee
authors.affiliation: Department of Surgery, Lenox Hill Hospital, 100 East 77th Street, New York, NY, 10075, USA.
authors.forename: Erica
authors.initials: E
authors.lastname: Bromberg
authors.affiliation: Department of Surgery, Lenox Hill Hospital, 100 East 77th Street, New York, NY, 10075, USA.|Northern Westchester Hospital Center, Mt Kisco, NY, USA.
authors.forename: Mitchell S
authors.initials: MS
authors.lastname: Roslin
mesh_terms: D000328:Adult; D005260:Female; D005743:Gastrectomy; D015390:Gastric Bypass; D018530:Gastric Stump; D000069196:Gastrointestinal Microbiome; D016481:Helicobacter Infections / Q000150:complications*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D009767:Obesity, Morbid / Q000150:complications* / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D013270:Stomach / Q000382:microbiology* / Q000601:surgery*; D016896:Treatment Outcome
keywords: Bariatric surgery; Complications; Helicobacter pylori; Laparoscopic sleeve gastrectomy; Lenox Hill Hospital; Microbiome; Obesity; Outcomes; RYGB; Roux-en-Y gastric bypass; Triple therapy; VSG; Vertical sleeve gastrectomy