Preoperative management of obese patients undergoing bariatric surgery: Role of endoscopy and Helicobacter eradication

Obes Res Clin Pract. 2021 May-Jun;15(3):289-290. doi: 10.1016/j.orcp.2021.05.002. Epub 2021 May 13.


Background: Obesity is a pandemic disease associated to severe health problems. Management is usually multimodal, but many patients eventually need surgery to reduce weight. Many guidelines recommend endoscopy prior to surgery. This study reviews a series of patients undergoing sleeve gastrectomy to see whether endoscopy performance and histopathological findings influence surgery outcome.

Material and methods: Retrospective series of patients undergoing sleeve gastrectomy as bariatric procedure at a single institution. We have reviewed the demographic data, the associated pathologies, endoscopic findings prior to surgery, histopathological findings in the surgical resection specimen and postoperative complication rate.

Results: 259 patients fulfilled criteria for the study. Over 70% were women and the mean age was 46.9 (SD 9.8). Preoperative endoscopy was performed in 28.9% of the patients and biopsy only in 19.3%. Helicobacter pylori was detected in 28% of the patients undergoing endoscopy (either in the biopsy or the urease test) and eradicated before surgery in all the patients. Helicobacter pylori was present in 9.7% of the surgical resection specimens and its presence was significantly associated with the development of postoperative complications, mostly staple line leaks (p = 0.01).

Conclusion: Our study confirms that Helicobacter infection is significantly associated with postoperative complications after sleeve gastrectomy. It is therefore important to detect its presence and eradicate it before surgery.

Keywords: Complications; Helicobacter pylori infection; Obesity; Outcome; Sleeve gastrectomy.

Publication types

  • Letter

MeSH terms

  • Bariatric Surgery* / adverse effects
  • Female
  • Gastrectomy / adverse effects
  • Helicobacter*
  • Humans
  • Laparoscopy*
  • Middle Aged
  • Obesity / surgery
  • Obesity, Morbid* / surgery
  • Retrospective Studies