Efficacy of Standard Triple Therapy for Helicobacter pylori Eradication and Early Postoperative Complications in Patients Undergoing Roux-en-Y Gastric Bypass

Abstract

Objective:

We aimed to evaluate the efficacy of standard triple therapy (STT) for Helicobacter pylori (HP) eradication and early postoperative complications in patients undergoing Roux-en-Y gastric bypass (RYGB).

Methods:

This prospective observational study included 543 patients submitted to RYGB (81.6% females, aged = 38 ± 9 years, body mass index = 41.7 [38.4–45.4] kg/m²). Before surgery, they collected biopsies through upper gastrointestinal endoscopy (UGE), which were HP-positive or HP-negative. STT-treated HP-positive patients who collected intraoperative gastric mucosa specimens. These patients were reclassified according to HP-eradication or HP-noneffective through histological analysis. All patients were followed up for 30 days after surgery to assess complications.

Results:

Before surgery, 36.4% of patients were HP-positive, and the first-line STT was effective at 90.9%. No differences between groups were detected for clinical complications and UGE data, except for the percentage of endoscopy and dilations, predominantly occurring in the HP-negative group. Symptoms of gastrointestinal bleeding and stenosis were reported, respectively, in 2% and 6.4% of HP-negative patients, with no difference between groups. No patient of the HP-positive group underwent endoscopic dilation. No postoperative clinical complications were noticed in the HP-noneffective group.

Conclusions:

Before surgery, STT effectively eradicated HP infection in most treated patients, but HP persistence did not influence complications or mortality during 30 days after surgery.