Histopathological Findings of Gastric Specimens after Sleeve Gastrectomy

Shorsh Hama Hussein  Ameen; Karzan Seerwan  Abdullah; Karwkh Hassan  Salih

doi:10.56056/

Authors

Shorsh Hama Hussein Ameen MBChB, FKHCMS in General surgery, KHCMS -subspecialty of digestive and hepatic surgery, Lecturer in Branch of Clinical Sciences, College of Medicine, University of Sulaimani
Karzan Seerwan Abdullah MBChB, FIBMS in General surgery, PDF in Hepatic and pancreatic surgery, Assistant Professor in Branch of Clinical Sciences, College of Medicine, University of Sulaimani, Iraq.
Karwkh Hassan Salih MBChB, FIBMS in Pathology, Lecturer in Branch of Clinical Sciences, College of Medicine, University of Sulaimani, Sulaymaniyah, Iraq.

DOI:

https://doi.org/10.56056/

Keywords:

Gastric specimens, Histopathological findings, Laparoscopy, Sleeve gastrectomy

Abstract

Background and objectives: Sleeve gastrectomy is considered a safe and practicable bariatric procedure. Despite recommending preoperative gastroscopy to rule out considerable pathologies, resected gastric specimens should be sent for histopathological examination to reveal any severe findings without suggestive clinical symptoms. Thus, this study aimed to identify the most common abnormal histopathological finding after sleeve laparoscopic gastrectomy.

Methods: This retrospective descriptive, cross-sectional study included 250 patients underwent laparoscopic sleeve gastrectomy for obesity from January, 2020 to January, 2024 at (Gastroenterology and Hepatology) Teaching Hospital and Zhian Private Hospital in Sulaymaniyah, Iraq. The patients’ sociodemographic data (age, sex, weight, and height) with their histopathological reports of gastric samples were collected from patient’s records. Abnormal histopathological findings after sleeve gastrectomy were described.

Results: Most patients were aged 18 - 44 years (n= 189, 75.6%), females (n= 175, 70%), and had a body mass index of <40 kg/m² (n= 114, 45.6%). Non-specific active chronic gastritis (n= 70, 28.0%) and Helicobacter pylori-positive active chronic follicular gastritis (n= 23, 9.2%) were more common among operated patients. A highly significant (p< 0.001) difference was observed between the patient's gender and histopathological findings (which gender was more affected?). In contrast, a substantial difference (p=0.01) was observed between patients' body mass index categories and different types of gastritis.

Conclusions: Sleeve gastrectomy results in abnormal histopathological findings among most patients, especially young females.

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References

1. Chooi YC, Ding C, Magkos F. The epidemiology of obesity. Metabolism. 2019, 92:6-10.

2. Aljerian K. Histopathological findings in laparoscopic sleeve gastrectomy specimens from patients with obesity in Saudi Arabia. Gastroenterol Res Pract. 2018, 2018(1):1702705.

3. Safaan T, Bashah M, El Ansari W, Karam M. Histopathological changes in laparoscopic sleeve gastrectomy specimens: prevalence, risk factors, and value of routine histopathologic examination. Obes Surg. 2017, 27:1741-1749.

4. Cayci HM, Erdogdu UE, Demirci H, Ardic A, Topak NY, Taymur İ. Effect of health literacy on help-seeking behavior in morbidly obese patients agreeing to bariatric surgery. Obes Surg. 2018, 28:791-797.

5. Deghles A, Dana M, Obeid A, Ahmed AB, Khatib Y, Ghanem A, Maree M. Findings of the Histopathology of Resected Stomach Specimens Following a Sleeve Gastrectomy at Al-Makassed Hospital from 2017 to 2023-Can a Selective Approach Be Recommended Available at: https://papers.ssrn.com/sol3/papers.cfm abstract_id=4854634/

6. Rashdan M, Mansour H, Odeh G, Abu-dawood R, Otoom G, Foudeh D et al. Histopathology findings of resected gastric specimens post sleeve gastrectomy: A cross-sectional study. Int J Surg Open. 2022, 43:100485.

7. Chung AY, Thompson R, Overby DW, Duke MC, Farrell TM. Sleeve gastrectomy: surgical tips. J Laparoendosc Adv Surg Tech. 2018, 28(8):930-937.

8. Khaitan L, Shea BJ. Laparoscopic vertical sleeve gastrectomy, long and short-term impact on weight loss and associated co-morbidities. Ann Transl Med. 2020, 8(Suppl 1): S5.

9. Alessandris R, Moroso F, Michelotto M, Fassan M, Angerilli V, Callegari L, Foletto M. Preoperative endoscopy and pathology report of the specimen to be recommended in sleeve gastrectomy Pathologica 2023, 115(2):90.

10. Onzi TR, d’Acampora AJ, de Araújo FM, Baratieri R, Kremer G, Lyra HF, et al. Gastric histopathology in laparoscopic sleeve gastrectomy: pre-and post-operative comparison. Obes Surg. 2014, 24:371-376.

11. Ge L, Moon RC, Nguyen H, de Quadros LG, Teixeira AF, Jawad MA. Pathologic findings of the removed stomach during sleeve gastrectomy. Surg Endosc. 2019, 33:4003-4007.

12. Tomasicchio G, Picciariello A, Dibra R, Lantone G, Trigiante G, De Fazio M, Martines G. Histopathologic findings on removed stomach after sleeve gastrectomy. Do they influence the outcome Open Med. 2022, 17(1):485-491.

13. Mantero P, Matus GS, Corti RE, Cabanne AM, de Palma GGZ, Olid LM et al. Helicobacter pylori and corpus gastric pathology are associated with lower serum ghrelin. World J Gastroenterol. 2018, 24(3):397.

14. Al Saady R, Ejeckam G. Histopathological findings in laparoscopic sleeve gastrectomy specimens. Qatar Med J. 2019, 2019(1):5.

15. Demirbas BT, Erdim A, Celikel C, Akbas G, Cingi A. Is it necessary to send the sleeve gastrectomy specimens to pathology Surg Laparosc Endosc Percutan Tech. 2019, 29(2):117-119.

16. Nowak K, DiPalma A, Serra S, Quereshy F, Jackson T, Okrainec A, Chetty R. Review of pathological findings in laparoscopic sleeve gastrectomy specimens performed for morbid obesity. J Clin Pathol. 2020, 73(10):618-623.

17. Miller GC, Reid AS, Brown IS. The pathological findings seen in laparoscopic sleeve gastrectomies for weight loss. Pathology 2016, 48(3):228-232.

18. Taha-Mehlitz S, Mongelli F, Sykora M, Scheiwiller A, Diebold J, Metzger J, Gass J-M. Routine histopathologic examination of the resected specimen after laparoscopic sleeve gastrectomy–what can be expected Acta Chirurgica Belgica 2021, 121(6):380-385.

19. Saafan T, El Ansari W, Bashah M. Compared to what? Is BMI associated with histopathological changes in laparoscopic sleeve gastrectomy specimens? Obes Surg. 2019, 29:2166-2173.

20. Adalı Y, Binnetoğlu K, Eroğlu HA, Kaya N, Güvendi GF. The relationship between histopathologic findings and body mass index in sleeve gastrectomy materials. Obes Surg. 2019, 29:277-280.