Spontaneous Elimination of Helicobacter pylori Infection After Bariatric Surgery: Effect of Sleeve Gastrectomy

Öz

Aim: This study aimed to evaluate the spontaneous postoperative negativization rate of preoperative Helicobacter pylori (H. pylori) positivity in obese patients undergoing sleeve gastrectomy, without any eradication therapy. Materials: Twenty-three patients who underwent primary laparoscopic sleeve gastrectomy between 2020 and 2024 were included. Preoperative H. pylori positivity was confirmed by histology, rapid urease test, urea breath test, or stool antigen test. H. pylori status was reassessed at 6 and 12 months postoperatively. Demographic, metabolic, and endoscopic data were recorded. Spontaneous elimination was defined as a negative test confirmed by two different diagnostic methods. Results: At 12 months, 12 patients were H. pylori-negative, with a total spontaneous elimination rate of 52.2%. Transient negativization at 6 months was 45.0%. The mean gastritis score was 2.1 ± 0.6 in patients who became negative versus 3.0 ± 0.7 in those who remained positive (p = 0.012). HOMA-IR decreased from 4.9 ± 2.3 to 2.6 ± 1.4 (p < 0.001). Significant reductions in total cholesterol, LDL, and triglycerides, and an increase in HDL were observed (p < 0.05). All three patients who developed ulcers remained H. pylori-positive (p = 0.037). Conclusion: After sleeve gastrectomy, H. pylori may spontaneously disappear in a substantial proportion of patients without eradication therapy, associated with metabolic improvement. Postoperative monitoring and standard test confirmation are important for patient safety and effective antibiotic stewardship.

Anahtar Kelimeler

• Sleeve gastrectomy
• Helicobacter pylori
• spontaneous elimination
• obesity
• metabolic improvement
• bariatric surgery

Obezite Cerrahisi Sonrası Helicobacter pylori Enfeksiyonunun Spontan Eliminasyonu: Sleeve Gastrektomi Etkisi

Öz

Amaç: Bu çalışmanın amacı, sleeve gastrektomi uygulanan obez hastalarda preoperatif Helicobacter pylori pozitifliğinin, herhangi bir eradikasyon tedavisi uygulanmadan postoperatif dönemde spontan olarak negatifleşme oranını değerlendirmektir. Materyal: 2020–2024 yılları arasında primer laparoskopik sleeve gastrektomi yapılan 23 hasta çalışmaya dahil edildi. Preoperatif H. pylori pozitifliği histoloji, hızlı üreaz testi, üre nefes testi veya dışkı antijen testi ile doğrulandı. Postoperatif 6. ve 12. aylarda H. pylori durumu yeniden değerlendirildi. Demografik, metabolik ve endoskopik veriler kaydedildi. Spontan eliminasyon, iki farklı tanı yöntemiyle doğrulanmış negatif test olarak kabul edildi. Bulgular: 12. ayda 12 hastada H. pylori negatifleşti, toplam spontan eliminasyon oranı %52.2 olarak bulundu. 6. ayda geçici negatifleşme %45.0 idi. Negatifleşen olgularda ortalama gastrit skoru 2.1 ± 0.6 iken, pozitif kalanlarda 3.0 ± 0.7 idi (p = 0.012). HOMA-IR değeri 4.9 ± 2.3’ten 2.6 ± 1.4’e geriledi (p < 0.001). Total kolesterol, LDL ve trigliseridlerde anlamlı azalma, HDL’de artış gözlendi (p < 0.05). Ülser gelişen 3 olgunun tamamında H. pylori pozitifliği sürdü (p = 0.037). Sonuç: Sleeve gastrektomi sonrası H. pylori, metabolik iyileşme ile ilişkili olarak, hastaların önemli bir kısmında eradikasyon tedavisi olmadan spontan olarak ortadan kalkabilir. Postoperatif izlem ve standart test doğrulaması, hasta güvenliği ve antibiyotik kullanım etkinliği açısından önemlidir.

Anahtar Kelimeler

• Sleeve gastrektomi
• Helicobacter pylori
• spontan eliminasyon
• obezite
• metabolik iyileşme
• bariatrik cerrahi

Kaynakça

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