Effect of Helicobacter pylori infection on metabolic and bariatric surgical complications: a systematic review and meta-analysis.

Abstract

More papers have discussed the importance of preoperative detection and eradication of Helicobacter pylori (HP) in patients before and after Metabolic and Bariatric Surgery (MBS). This systematic review and meta-analysis aimed to evaluate the role of preoperative H. pylori eradication vs non-treatment in the development of post-op complications in the setting of bariatric and metabolic surgery. This study aimed to evaluate the effect of Helicobacter pylori (HP) on metabolic and bariatric surgical complications through a systematic review and meta-analysis. A systematic search on the influence of HP infection on postoperative complications in bariatric surgery was conducted. The methodological quality of the included studies was rated using the Newcastle-Ottawa Rating scale. In case of consistent reporting of the data, a meta-analysis was performed. A total of 19 studies containing 261,186 patients were included. The mean age of the patients was 41.88 ± 7.40 years with a mean BMI of 45.53 ± 3.16 kg/m². The mean follow-up was 21.72 months (range: 1-96 months). Testing for HP infections was often done using an esophagogastroduodenoscopy in combination with biopsy (42%). A urea breath test (59%) was the most common tool to confirm eradication. To eradicate HP, 2 weeks of PPI with antibiotics, 1 week of PPI with antibiotics, and PPI alone without antibiotics were used in 18 (67%), 3 (11%), and 6 (22%) studies, respectively. The prevalence of complications among patients with positive/negative HP was not significantly different (P > 0.05). In HP patients without preoperative eradication, odds ratio of bleeding was 1.48 (95% CI 0.80-2.73), ulcer was 6.88 (95% CI 5.60-8.45), leakage was 1.73 (95% CI 0.81-3.68), stricture was 1.13 (95% CI 0.30-4.21), and abscesses was 3.01 (95% CI 0.85-10.65). Helicobacter pylori infection is associated with potential postoperative complications, and therefore, it needs adequate treatment.