INFLAMMATORY DISORDERS ASSOCIATED WITH HELICOBACTER PYLORI IN THE ROUX-EN-Y BYPASS GASTRIC POUCH

ABSTRACT Background: The prevalence of Helicobacter pylori in obese candidates for bariatric surgery and its role in the emergence of inflammatory lesions after surgery has not been well established. Aim: To identify the incidence of inflammatory lesions in the stomach after bariatric surgery and to correlate it with H. pylori infection. Methods: This is a prospective study with 216 patients undergoing Roux-en-Y gastric bypass. These patients underwent histopathological endoscopy to detect H. pylori prior to surgery. Positive cases were treated with antibiotics and a proton inhibitor pump followed by endoscopic follow-up in the 6th and 12th month after surgery. Results: Most patients were female (68.1%), with grade III obesity (92.4%). Preoperative endoscopy revealed gastritis in 96.8%, with H. pylori infection in 40.7% (88/216). A biopsy was carried out in 151 patients, revealing H. pylori in 60/151, related to signs of inflammation in 90% (54/60). In the 6th and 12th month after surgery, the endoscopy and the histopathological exam showed a normal gastric pouch in 84% of patients and the incidence of H. pylori was 11% and 16%, respectively. The presence of inflammation was related to H. pylori infection (p摘要 背景：拟接受减重手术的肥胖人群中幽门螺杆菌（Helicobacter pylori）的感染率，及其在术后炎性病变发生中的作用尚未明确。目的：明确减重术后胃部炎性病变的发生率，并探讨其与幽门螺杆菌感染的相关性。方法：本研究为前瞻性研究，共纳入216例行Roux-en-Y胃旁路术（Roux-en-Y gastric bypass）的患者。所有患者术前均接受内镜下组织病理学检查以检测幽门螺杆菌感染。幽门螺杆菌阳性患者接受抗生素联合质子泵抑制剂（proton pump inhibitor）治疗，并于术后第6、12个月行内镜随访。结果：本研究受试者中女性占比68.1%，Ⅲ级肥胖者占92.4%。术前内镜检查显示96.8%的患者存在胃炎，其中40.7%（88/216）合并幽门螺杆菌感染。151例患者接受了活检，其中60例检测出幽门螺杆菌感染，该60例患者中90%（54/60）存在炎性体征。术后第6、12个月的内镜及组织病理学检查显示，84%的患者胃储袋形态正常，幽门螺杆菌感染率分别为11%与16%。炎性病变的发生与幽门螺杆菌感染相关（p