Helicobacter pylori (HP) infection has an association with postoperative complications after bariatric surgery, but the relationship between them is controversial in the literature. The aim of this meta-analysis is to investigate the influence of HP infection on postoperative outcomes in patients undergoing bariatric surgery.
Materials and Methods:
We performed a literature search in the PubMed, EMBASE, Web of Science, and the Cochrane Library to identify eligible articles published from inception up to October 1, 2019. Study quality was assessed using the Newcastle-Ottawa scale.
Results:
Twelve studies involving 257,331 patients were finally included in the study. The summary results showed that there was no significant influence of HP infection on postoperative complications (odds ratio 1.87; 95% confidence interval [CI] 0.69–5.03; p = 0.22). However, sensitivity analysis showed that a decreased percentage excess weight loss (%EWL) at 1 year was detected in HP-positive patients (mean difference −3.41; 95% CI −5.90 to −0.92; p = 0.007).
Conclusions:
This meta-analysis has demonstrated that no significantly adverse association was found between HP infection with postoperative complications. A decreased %EWL at 1 year after bariatric surgery might be associated with HP infection.
Get full access to this article
View all access options for this article.
References
1.
MarshallBJ, WarrenJR. Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet, 1984; 1:1311–1315.
KhatoonJ, RaiRP, PrasadKN. Role of Helicobacter pylori in gastric cancer: updates. World J Gastrointest Oncol, 2016; 8:147–158.
4.
ZamaniM, EbrahimtabarF, ZamaniV, MillerWH, Alizadeh-NavaeiR, Shokri-ShirvaniJ, et al.Systematic review with meta-analysis: the worldwide prevalence of Helicobacter pylori infection. Aliment Pharmacol Ther, 2018; 47:868–876.
5.
ArslanE, AtilganH, YavasogluI. The prevalence of Helicobacter pylori in obese subjects. Eur J Intern Med, 2009; 20:695–697.
6.
DuttaSK, AroraM, KireetA, BashandyH, GandsasA. Upper gastrointestinal symptoms and associated disorders in morbidly obese patients: a prospective study. Dig Dis Sci, 2009; 54:1243–1246.
7.
FruhbeckG.Bariatric and metabolic surgery: a shift in eligibility and success criteria. Nat Rev Endocrinol, 2015; 11:465–477.
8.
SebunovaN, StsepetovaJ, SillakiviT, MandarR. The prevalence of Helicobacter pylori in Estonian bariatric surgery patients. Int J Mol Sci, 2018; 19:pii:E338.
9.
VanekVW, CataniaM, TriveriK, WoodruffRWJr. Retrospective review of the preoperative biliary and gastrointestinal evaluation for gastric bypass surgery. Surg Obes Relat Dis, 2006; 2:17–22; discussion 22–23.
10.
RasmussenJJ, FullerW, AliMR. Marginal ulceration after laparoscopic gastric bypass: an analysis of predisposing factors in 260 patients. Surg Endosc, 2007; 21:1090–1094.
11.
MocanuV, DangJT, SwitzerN, SkublenyD, ShiX, de GaraC, et al.The effect of Helicobacter pylori on postoperative outcomes in patients undergoing bariatric surgery: a systematic review and meta-analysis. Obes Surg, 2018; 28:567–573.
12.
WellsG, SheaB, O'ConnellJ. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa Health Research Institute Web site 2014. Available at www.ohri.ca/programs/clinical_epidemiology/oxford.asp, (last accessed April27, 2020).
13.
RamaswamyA, LinE, RamshawBJ, SmithCD. Early effects of Helicobacter pylori infection in patients undergoing bariatric surgery. Arch Surg, 2004; 139:1094–1096.
14.
WangHH, LeeWJ, LiewPL, YangCS, LiangRJ, WangW, et al.The influence of Helicobacter pylori infection and corpus gastritis on the postoperative outcomes of laparoscopic vertical banded gastroplasty. Obes Surg, 2006; 16:297–307.
15.
YangCS, LeeWJ, WangHH, HuangSP, LinJT, WuMS. The influence of Helicobacter pylori infection on the development of gastric ulcer in symptomatic patients after bariatric surgery. Obes Surg, 2006; 16:735–739.
16.
RossettiG, MocciaF, MarraT, BuonomoM, PascottoB, PezzulloA, et al.Does Helicobacter pylori infection have influence on outcome of laparoscopic sleeve gastrectomy for morbid obesity?. Int J Surg, 2014; 12Suppl 1:S68–S71.
17.
BrownleeAR, BrombergE, RoslinMS. Outcomes in patients with Helicobacter pylori undergoing laparoscopic sleeve gastrectomy. Obes Surg, 2015; 25:2276–2279.
18.
GomberawallaA, LutfiR. Early outcomes of Helicobacter pylori and its treatment after laparoscopic sleeve gastrectomy. Bariatric Surg Pract Patient Care, 2015; 10:12–14.
19.
Gonzalez-HerediaR, TiradoV, PatelN, MasrurM, MurpheyM, ElliE. Is Helicobacter pylori associated with an increased complication rate after sleeve gastrectomy?. Bariatric Surg Pract Patient Care, 2015; 10:15–18.
20.
KellyJJ, PeruginiRA, WangQL, CzerniachDR, FlahiveJ, CohenPA. The presence of Helicobacter pylori is not associated with long-term anastomotic complications in gastric bypass patients. Surg Endosc, 2015; 29:2885–2890.
21.
SchulmanAR, AbougergiMS, ThompsonCC. H-pylori as a predictor of marginal ulceration: a nationwide analysis. Obesity, 2017; 25:522–526.
22.
ShantiH, AlmajaliN, Al-ShamailehT, SamarahW, MismarA, ObeidatF. Helicobacter pylori does not affect postoperative outcomes after sleeve gastrectomy. Obes Surg, 2017; 27:1298–1301.
23.
SerinKR, AkyuzU, BatmanB, UymazDS, AltunH. Does Helicobacter pylori infection influence the major postoperative complication rate after sleeve gastrectomy? A retrospective cohort study in an endemic region. Turk J Gastroenterol, 2018; 29:379–383.
PandeyR, MisraV, MisraSP, DwivediM, KumarA, TiwariBK. Helicobacter pylori and gastric cancer. Asian Pac J Cancer Prev, 2010; 11:583–588.
26.
RoperJ, FrancoisF, ShuePL, MouradMS, PeiZ, Olivares de PerezAZ, et al.Leptin and ghrelin in relation to Helicobacter pylori status in adult males. J Clin Endocrinol Metab, 2008; 93:2350–2357.
27.
JangEJ, ParkSW, ParkJS, ParkSJ, HahmKB, PaikSY, et al.The influence of the eradication of Helicobacter pylori on gastric ghrelin, appetite, and body mass index in patients with peptic ulcer disease. J Gastroenterol Hepatol, 2008; 23:S278–S285.
28.
DhurandharNV, BaileyD, ThomasD. Interaction of obesity and infections. Obes Rev, 2015; 16:1017–1029.
29.
GodayA, CastañerO, BenaigesD, PouAB, RamónJM, IglesiasMDM, et al.Can Helicobacter pylori eradication treatment modify the metabolic response to bariatric surgery?. Obes Surg, 2018; 28:2386–2395.
30.
ConsidineRV, SinhaMK, HeimanML, KriauciunasA, StephensTW, NyceMR, et al.Serum immunoreactive-leptin concentrations in normal-weight and obese humans. N Engl J Med, 1996; 334:292–295.
31.
Romo-GonzálezC, MendozaE, MeraRM, Coria-JimenezR, Chico-AldamaP, Gomez-DiazR, et al.Helicobacter pylori infection and serum leptin, obestatin, and ghrelin levels in Mexican schoolchildren. Pediatr Res, 2017; 82:607–613.
32.
MixH, WidjajaA, JandlO, CornbergM, KaulA, GokeM, et al.Expression of leptin and leptin receptor isoforms in the human stomach. Gut, 2000; 47:481–486.
33.
SobhaniI, BadoA, VissuzaineC, BuyseM, KermorgantS, LaigneauJP, et al.Leptin secretion and leptin receptor in the human stomach. Gut, 2000; 47:178–183.
34.
PlonkaM, BielanskiW, KonturekSJ, TargoszA, SliwowskiZ, DobrzanskaM, et al.Helicobacter pylori infection and serum gastrin, ghrelin and leptin in children of Polish shepherds. Dig Liver Dis, 2006; 38:91–97.
35.
AzaguryDE, Abu DayyehBK, GreenwaltIT, ThompsonCC. Marginal ulceration after Roux-en-Y gastric bypass surgery: characteristics, risk factors, treatment, and outcomes. Endoscopy, 2011; 43:950–954.
36.
PapasavasPK, GagneDJ, DonnellyPE, SalgadoJ, UrbandtJE, BurtonKK, et al.Prevalence of Helicobacter pylori infection and value of preoperative testing and treatment in patients undergoing laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis, 2008; 4:383–388.
FranceschiF, AnnalisaT, TeresaDR, GiovannaD, IaniroG, FrancoS, et al.Role of Helicobacter pylori infection on nutrition and metabolism. World J Gastroenterol, 2014; 20:12809–12817.
39.
AlbawardiA, AlmarzooqiS, TorabFC. Helicobacter pylori in sleeve gastrectomies: prevalence and rate of complications. Int J Clin Exp Med, 2013; 6:140–143.
40.
RawlinsL, RawlinsMP, BrownCC, SchumacherDL. Effect of Helicobacter pylori on marginal ulcer and stomal stenosis after Roux-en-Y gastric bypass. Surg Obes Relat Dis, 2013; 9:760–764.
