Gastric histopathologies in patients undergoing laparoscopic sleeve gastrectomies

Obes Surg. 2013 Mar;23(3):314-9. doi: 10.1007/s11695-012-0821-y.

Abstract

Background: With 80 % of its population overweight, 47.5 % obese, and having the eighth fattest population worldwide, Kuwait has a serious obesity problem. This has led to widespread practice of bariatric surgery, with little or no studies regarding operative findings and patient follow-up. This study aims to identify the prevalent gastric histopathologies of the patients who have undergone laparoscopic sleeve gastrectomy (LSG) at Amiri Hospital, Kuwait.

Methods: A retrospective study was done of the gastric pathology specimen results of 656 patients who underwent LSG at Amiri Hospital from 2008 to 2012.

Results: Of the 656 patients, the average age was 33 years, and 480 (73.2 %) were female while 176 (26.8 %) were male. The histopathology results identified 488 (74.4 %) cases with chronic gastritis, 63 (9.6 %) with follicular gastritis, and 12 (1.8 %) with atrophic gastritis. A total of 12 (1.8 %) cases showed findings other than gastritis, including four (0.6 %) cases of gastric polyps, three (0.5 %) cases of granulomatous disease, and one (0.2 %) case each of the following: gastro-intestinal stromal tumor, gastro-intestinal autonomic nerve tumor, intestinal metaplasia, collagenous gastritis, and crypt cell apoptosis. Helicobacter pylori was discovered in 48 (7.3 %) of the patients.

Conclusions: The majority of gastric histopathology results after LSG in this study had an element of chronic gastritis (74.4 %), which is in keeping with previous studies showing its high prevalence among the obese population. However, a few cases had clinically significant pathologies, and this may alter post-operative management. In view of these results, routine histological examination of the gastric specimens is highly recommended.

MeSH terms

  • Adult
  • Chronic Disease
  • Female
  • Follow-Up Studies
  • Gastric Mucosa / pathology*
  • Gastritis / epidemiology
  • Gastritis / pathology*
  • Gastroplasty / methods*
  • Helicobacter Infections / epidemiology
  • Helicobacter Infections / pathology*
  • Helicobacter pylori / isolation & purification
  • Humans
  • Immunohistochemistry
  • Intestinal Polyps / epidemiology
  • Intestinal Polyps / pathology*
  • Kuwait / epidemiology
  • Laparoscopy / methods
  • Male
  • Metaplasia / epidemiology
  • Middle Aged
  • Obesity, Morbid / epidemiology
  • Obesity, Morbid / pathology*
  • Preoperative Care / methods*
  • Prevalence
  • Retrospective Studies