Hendrika J M Smelt1, Johannes F Smulders2, Lennard P L Gilissen3, Mohammed Said2, Surendra Ugale4, Sjaak Pouwels5. 1. Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands; Obesity Center, Catharina Hospital, Eindhoven, the Netherlands. Electronic address: marieke.smelt@catharinaziekenhuis.nl. 2. Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands; Obesity Center, Catharina Hospital, Eindhoven, the Netherlands. 3. Department of Gastroenterology, Catharina Hospital, Eindhoven, the Netherlands. 4. Bariatric & Metabolic Surgery Clinic, Kirloskar Hospital, Hyderabad, India. 5. Franciscus Gasthuis & Vlietland, Rotterdam/Schiedam, the Netherlands.
Abstract
BACKGROUND: Numerous papers have discussed the importance of preoperative detection and eradication of Helicobacter pylori (HP) in bariatric patients. OBJECTIVES: This systematic review specifically focuses on the influence of HP infection on clinical symptoms, complications, and abnormal endoscopic findings in postbariatric patients. METHODS: A systematic search on the influence of HP infection on postoperative complications in bariatric surgery was conducted. The methodologic quality of the included studies was rated using the Newcastle-Ottawa rating scale. The agreement between the reviewers was assessed with Cohen's kappa. The included studies were assessed into 2 groups, studies with and without eradication therapy preoperatively. RESULTS: A total of 21 studies were included with a methodologic quality ranging from poor to good. The agreement between the reviewers, assessed with the Cohen's kappa, was .70. Overall, tendency in the included studies was that HP infection was associated with an increased risk for developing marginal ulcers and postoperative complications. A meta-analysis on the incidence of marginal ulcers and overall postoperative complications was conducted and showed, respectively, an odds ratio of .508 (.031-8.346) and 2.863 (.262-31.268). CONCLUSIONS: HP is frequently found in patients before and after bariatric and metabolic surgery. We assessed whether, according to the current literature, HP increases the risk for developing postoperative complications after surgery. This meta-analysis shows that a methodologically good study should be performed to clarify the role of HP in bariatric patients and the question of whether HP should be eradicated before surgery.
BACKGROUND: Numerous papers have discussed the importance of preoperative detection and eradication of Helicobacter pylori (HP) in bariatric patients. OBJECTIVES: This systematic review specifically focuses on the influence of HP infection on clinical symptoms, complications, and abnormal endoscopic findings in postbariatric patients. METHODS: A systematic search on the influence of HP infection on postoperative complications in bariatric surgery was conducted. The methodologic quality of the included studies was rated using the Newcastle-Ottawa rating scale. The agreement between the reviewers was assessed with Cohen's kappa. The included studies were assessed into 2 groups, studies with and without eradication therapy preoperatively. RESULTS: A total of 21 studies were included with a methodologic quality ranging from poor to good. The agreement between the reviewers, assessed with the Cohen's kappa, was .70. Overall, tendency in the included studies was that HP infection was associated with an increased risk for developing marginal ulcers and postoperative complications. A meta-analysis on the incidence of marginal ulcers and overall postoperative complications was conducted and showed, respectively, an odds ratio of .508 (.031-8.346) and 2.863 (.262-31.268). CONCLUSIONS:HP is frequently found in patients before and after bariatric and metabolic surgery. We assessed whether, according to the current literature, HP increases the risk for developing postoperative complications after surgery. This meta-analysis shows that a methodologically good study should be performed to clarify the role of HP in bariatric patients and the question of whether HP should be eradicated before surgery.
Authors: Nicola Di Lorenzo; Stavros A Antoniou; Rachel L Batterham; Luca Busetto; Daniela Godoroja; Angelo Iossa; Francesco M Carrano; Ferdinando Agresta; Isaias Alarçon; Carmil Azran; Nicole Bouvy; Carmen Balaguè Ponz; Maura Buza; Catalin Copaescu; Maurizio De Luca; Dror Dicker; Angelo Di Vincenzo; Daniel M Felsenreich; Nader K Francis; Martin Fried; Berta Gonzalo Prats; David Goitein; Jason C G Halford; Jitka Herlesova; Marina Kalogridaki; Hans Ket; Salvador Morales-Conde; Giacomo Piatto; Gerhard Prager; Suzanne Pruijssers; Andrea Pucci; Shlomi Rayman; Eugenia Romano; Sergi Sanchez-Cordero; Ramon Vilallonga; Gianfranco Silecchia Journal: Surg Endosc Date: 2020-04-23 Impact factor: 4.584