Post Helicobacter pylori Treatment Histopathological Findings in Laparoscopic Sleeve Gastrectomy Specimens.

Abstract

Abstract Background:: The aim of this study is to investigate the persistent histopathologic changes after H pylori treatment in laparoscopic sleeve gastrectomy (LSG) specimens and wethere there is correlation between high BMI and histopathological findings. Methods: Patients who were candidate for laparoscopic sleeve gastrectomy in 2017-2019 and they were asymptomatic with negative history of Helicobacter pylori and had visually normal endoscopy and just have posotive H pylori ureas test treated with triple regimen(clarithromycin and amoxycillin for 2weeks and PPI for 2 mounth and then confirming eradication by Urea Breath Test (UBT) and after operation specimens were evaluated histopathologically. Results: Females comprised 58.3 % of the patients. Mean BMI were 44.2 (females) and 46.3 (males). Normal LSG specimens comprised 58.3 %. Most common abnormal histopathologies were; chronic mild active and inactive gastritis (21.3%), chronic moderate active and inactive gastritis (16.0%), chronic severe active and inactive gastritis(3.3% ),no follicular gastritis, lymphoid aggregates (0.6 %), intestinal metaplasia ( 0.2%) and  PPI effect(0.2% ). Significant correlation was observed between the higher BMI of patients(BMI>45) with abnormal histopathologies specially moderate and severe degree of chronic  active and inactive gastritis. Conclusion:Petients with higher BMI is at more risk for post H pylori treatment abnormal pathology like chronic active gastritis which is the risk factor for atrophic gastritis may lead to preventable gastric cancer.so in this course patients with higher BMI(≥45) and Hpylori positive ureas test with visually normal endoscopy who are scheduled for LRYGB which permanent endoscopic follow up is impossible, provide benefits from endoscopic random tissue mapping even after H pylori treatment.