Nurullah BÜLBÜLLER, Osman Zekai ÖNER, Cemal Özben ENSARİ, Yaşar ÇÖPELCİ, Uğur DOĞAN, Mehmet Tahir ORUÇ

Laparoskopik Sleeve Gastrektominin Helicobacter pylori Enfeksiyonuna Etkisi

Amaç: Helicobacter pylori, birçok benign veya malign hastalığa neden olabilen çok yaygın bir patojendir. H. pylori tarafından kolonize edilenbireylerin çoğunluğu asemptomatiktir. H. pylori, obez hastalarda da yaygın şekilde saptanmıştır. Laparoskopik sleeve gastrektomi (LSG), obezitenintedavisinde en çok tercih edilen cerrahi seçeneklerden biridir. Bu çalışmada obez hastalarda LSG’nin H. pylori enfeksiyonuna etkisinin değerlendirilmesiamaçlanmıştır.Gereç ve Yöntem: Çalışmaya morbid obezite nedeniyle LSG planlanan ve operasyon öncesinde Karbon-14 üre nefes testi (ÜNT) ile H. pylori pozitifliğitesbit edilen toplam 36 hasta dahil edildi. Tüm hastalar postoperatif üçüncü ayda tekrar ÜNT yapılarak değerlendirildi. Hastaların asemptomatikolması sebebiyle ve de oluşabilecek yanlış negatif sonuçların önlenmesi amacıyla hiçbir hastaya hem preoperatif hem de postoperatif dönemdeantibiyotik ve proton pompası inhibitörü (PPİ) tedavisi verilmedi.Bulgular: Hastaların 29’u (%80) kadın, 7’si (%20) erkekti. Ortalama yaş 36 ve ortalama preoperatif vücut kitle indeksi 44 idi. Otuz altı hastanınpostoperatif ÜNT değerlendirmesi sonucunda 20 (%55) hastada H. pylori negatif bulundu. Bunlardan 4’ü erkek, 16’sı kadındı. Tüm hastalar H. pylorienfeksiyonu açısından postoperatif dönemde de asemptomatik seyretti.Sonuç: Hem obezite hem de H. pylori enfeksiyonu genel olarak halk sağlığını etkilemektedir ve ilgili komorbiditeleri önlemek için tedavi gereklidir.Bu çalışmada, LSG öncesi H. pylori enfeksiyonu olan 36 hastanın %55’inin postoperatif üçüncü ayda H. pylori enfeksiyonu açısından negatifolduğunu gördük. Sonuç olarak, LSG’nin H. pylori enfeksiyonunun tedavisinde etkili olduğu düşünülmektedir.

The Effect of Laparoscopic Sleeve Gastrectomy on Helicobacter pylori Infection

Objectives: Helicobacter pylori is a very common pathogen that can causes many benign or malign diseases. The majority of individuals colonized by H. pylori are asymptomatic although they have gastritis. H. pylori is also commonly detected in obese patients. Laparoscopic sleeve gastrectomy (LSG) is one of the most preferred surgical option in treatment of obesity. In this study, we aimed to evaluate the effect of LSG on H. pylori infection in obese patients. Materials and Methods: Totally 36 patients were included who were asymptomatic and had diagnosed with H. pylori infection positive by using Carbon-14 urea breathing test (UBT) before undergoing LSG. All of the patients were evaluated again by using same test in the postoperative third month. To prevent false negative results, and because the patients are asymptomatic, no antibiotics and proton pump inhibitors were given both in preoperative and postoperative period. Results: Twenty nine patients (80%) were female where 7 (20%) were male. Mean age was 36 and mean preoperative body mass index was Postoperative UBT was negative in 20 of 36 patients (55%). Four of these were male and 16 of these were female. Where 7 (20%) were male. All of the patients maintained asymptomatic postoperatively in terms of H. pylori infection. Conclusion: Both obesity and H. pylori infection commonly affect public health and should be treated in order to prevent related comorbidities. In this study we have seen that 55% of 36 patients that had H. pylori infection before LSG, became negative in terms of H. pylori infection in postoperative third month. In conclusion, LSG is thought to be effective in the treatment of H. pylori infection.

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