The Influence of Helicobacter pylori Infection and Corpus Gastritis on the Postoperative Outcomes of Laparoscopic Vertical Banded Gastroplasty |
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Authors: | Hsih-Hsi Wang MD Wei-Jei Lee MD PhD Phui-Ly Liew MD Chang-Shyue Yang MD Ren-Jow Liang MD Weu Wang MD Jaw-Town Lin MD PhD Ming-Shiang Wu MD PhD |
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Institution: | (1) EverHealth Clinic, Taipei, Taiwan;(2) Department of Surgery, Ming-Shen Hospital, Taipei, Taiwan;(3) Department of Pathology, En Chu Kong Hospital, Taipei, Taiwan;(4) Internal Medicine, En Chu Kong Hospital, Taipei, Taiwan;(5) Internal Medicine, En Chu Kong Hospital, Taipei, Taiwan;(6) Department of Surgery, Ming-Shen Hospital, Taipei, Taiwan;(7) Department of Internal Medicine and Primary Care Medicine, National Taiwan University Hospital, Taipei, Taiwan;(8) Department of Internal Medicine and Primary Care Medicine, National Taiwan University Hospital, Taipei, Taiwan |
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Abstract: | Background: Helicobacter pylori (HP) infection is linked to weight control through gastric inflammation-induced deregulation of satiety-related hormone,
and eradication of HP before a weight reduction operation has been advocated. We aimed to examine the impact of HP infection
and corpus gastritis on preoperative patient characteristics, postoperative complications and weight loss following laparoscopic
vertical banded gastroplasty (LVBG). Methods: A prospective cohort of 152 patients undergoing LVBG was enrolled. Gastric specimens
at the corpus were obtained during LVBG operation and scored histologically according to the Sydney classification of gastritis.
Excess weight loss, and early and late complications following LVBG, were recorded and correlated. Results: 63 and 89 patients
were identified as HP positive and negative groups respectively. The prevalence of individual components of the metabolic
syndrome was comparable in both groups except hypertension. The occurrence of early and late complications, either minor or
major, in both groups was similar. The severity of gastritis was correlated positively with age and negatively with preoperative
BMI and excess weight. Patients with higher neutrophil activity, chronic inflammation, and HP density experienced less excess
weight loss at 24 to 48 months follow-up. The impact of gastritis on weight loss became less recognizable after 48 months
follow-up. Conclusions: HP infection and gastric inflammation play a significant role in the amount of weight loss after LVBG.
Further prospective studies should examine possible mechanisms and long-term effects on weight loss to determine the utility
of preventive eradication of HP in different types of bariatric surgery. |
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Keywords: | HELICOBACTER PYLORI CORPUS GASTRITIS OUTCOMES VERTICAL BANDED GASTROPLASTY MORBID OBESITY |
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