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The need for a patient-tailored Helicobacter pylori eradication protocol prior to bariatric surgery
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The need for a patient-tailored Helicobacter pylori eradication protocol prior to bariatric surgery
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Journal Article
The need for a patient-tailored Helicobacter pylori eradication protocol prior to bariatric surgery
2018
Overview
Objective
High-quality data indicating the advantages of preoperative Helicobacter pylori screening and eradication as well the clinical outcomes of patients with and without H. pylori after bariatric surgery are lacking.
Methods
In total, 96 morbidly obese patients with H. pylori preparing for bariatric surgery were retrospectively reviewed.
Results
Of 96 biopsy specimens, 73 (76%) were positive for H. pylori on initial Giemsa staining. These patients were treated with the standard 7-day antibiotic treatment protocol corrected by the individual patient’s creatinine clearance rate and body mass index and received a 30% higher dose because of their H. pylori positivity. A linear correlation was found between the effective antibiotic dose and the BMI with a recurrence rate of only 2.1% (2/96 patients). The preoperative percent estimated weight loss before surgery (17%) and in the first year of follow-up (68%–88%) was statistically equal between H. pylori-positive and -negative patients. Two early postoperative infectious complications and two postoperative surgical complications occurred in the preoperatively H. pylori-positive patients.
Conclusions
A patient-tailored H. pylori eradication protocol prior to bariatric surgery is mandatory to improve the eradication rate and reduce the incidence of postoperative complications in mostly asymptomatic H. pylori-positive bariatric candidates.
Publisher
SAGE Publications,Sage Publications Ltd
Subject
/ Amoxicillin - administration & dosage
/ Anti-Bacterial Agents - administration & dosage
/ Anti-Ulcer Agents - administration & dosage
/ Esomeprazole - administration & dosage
/ Female
/ Helicobacter Infections - complications
/ Helicobacter Infections - diagnosis
/ Helicobacter Infections - drug therapy
/ Helicobacter pylori - isolation & purification
/ Humans
/ Male
/ Metronidazole - administration & dosage
/ Obesity, Morbid - complications
/ Patients
