Philipp W Raess1, Marilyn Baird-Howell1, Rajesh Aggarwal2, Noel N Williams2, Emma E Furth3. 1. Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. 2. Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania. 3. Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: eef@mail.med.upenn.edu.
Abstract
BACKGROUND: Laparoscopic vertical sleeve gastrectomy is used with increasing frequency as a therapeutic option for morbid obesity. Before the procedure, patients undergo a rigorous preoperative evaluation including double contrast upper gastrointestinal radiographic series at our institution. Patients undergoing sleeve gastrectomy are presumed to have no significant gastric pathology. OBJECTIVES: To investigate the prevalence of histopathologic findings requiring clinical follow-up in sleeve gastrectomy specimens. SETTING: University Hospital, United States. METHODS: Retrospective review was conducted of all primary vertical sleeve gastrectomy specimens performed for morbid obesity at our institution from July 2008 until August 2012 (N = 248). RESULTS: Unanticipated findings warranting clinical follow-up were identified in 8.4% of cases and included cases of H. pylori gastritis, autoimmune gastritis with microcarcinoid formation, necrotizing vasculitis, and intestinal metaplasia. H. pylori was identified in 5.2% of all cases and in 33.3% of cases of gastritis. Neoplasms were identified at laparoscopy in 2 additional cases (0.8%). CONCLUSIONS: Surgeons and pathologists should be aware of the high prevalence of diagnoses requiring clinical follow-up in vertical sleeve gastrectomy specimens.
BACKGROUND: Laparoscopic vertical sleeve gastrectomy is used with increasing frequency as a therapeutic option for morbid obesity. Before the procedure, patients undergo a rigorous preoperative evaluation including double contrast upper gastrointestinal radiographic series at our institution. Patients undergoing sleeve gastrectomy are presumed to have no significant gastric pathology. OBJECTIVES: To investigate the prevalence of histopathologic findings requiring clinical follow-up in sleeve gastrectomy specimens. SETTING: University Hospital, United States. METHODS: Retrospective review was conducted of all primary vertical sleeve gastrectomy specimens performed for morbid obesity at our institution from July 2008 until August 2012 (N = 248). RESULTS: Unanticipated findings warranting clinical follow-up were identified in 8.4% of cases and included cases of H. pylorigastritis, autoimmune gastritis with microcarcinoid formation, necrotizing vasculitis, and intestinal metaplasia. H. pylori was identified in 5.2% of all cases and in 33.3% of cases of gastritis. Neoplasms were identified at laparoscopy in 2 additional cases (0.8%). CONCLUSIONS: Surgeons and pathologists should be aware of the high prevalence of diagnoses requiring clinical follow-up in vertical sleeve gastrectomy specimens.
Authors: Li Ge; Rena C Moon; Ha Nguyen; Luiz Gustavo de Quadros; Andre F Teixeira; Muhammad A Jawad Journal: Surg Endosc Date: 2019-02-15 Impact factor: 4.584
Authors: Stefan Wolter; Anna Duprée; Jameel Miro; Cornelia Schroeder; Marie-Isabelle Jansen; Clarissa Schulze-Zur-Wiesch; Stefan Groth; Jakob Izbicki; Oliver Mann; Philipp Busch Journal: Obes Surg Date: 2017-08 Impact factor: 4.129