Histopathological Findings in Laparoscopic Sleeve Gastrectomy Specimens from Patients with Obesity in Saudi Arabia.

Khaldoon Aljerian

doi:10.1155/2018/1702705

Abstract

Laparoscopic sleeve gastrectomy is a bariatric surgical procedure performed in patients with morbid obesity that provides the opportunity to review histopathological changes. The aim of this study was to characterize resected gastric specimens obtained from a Saudi patient population at a single center for a prospectively maintained database of laparoscopic sleeve gastrectomy cases. The histopathological findings from all patients undergoing laparoscopic sleeve gastrectomies at King Khalid University Hospital between 2010 and 2015 were retrospectively reviewed. Of the 602 cases reviewed, the majority (83.4% [n = 502]) exhibited chronic gastritis, whereas 22.3% (n = 134) involved Helicobacter pylori infections with active gastritis, 1% (n = 6) had intestinal metaplasia, and one case (0.17%) revealed gastric adenocarcinoma. As the findings revealed conditions that are treatable, I highly recommend histological examinations of all sleeve gastrectomy specimens from a Saudi patient population.

Highlights

Obesity and its various comorbidities currently comprise the most serious, most prevalent, and most challenging health concerns worldwide [1, 2]
The cases were categorized into the following groups on the basis of the biopsy report findings: (i) normal histology of stomach, (ii) chronic active gastritis with Helicobacter pylori infection, (iii) chronic gastritis alone, (iv) follicular lymphoid hyperplasia, (v) intestinal metaplasia, (vi) dysplasia/carcinoma in situ, (vii) carcinoma, and (viii) other pathological entities
Histological examinations indicated that the majority (83.4% [502/602]) of specimens had submucosal lymphocytic and plasmacytic infiltrates and constituted the diagnoses of chronic gastritis (Figure 1(b))

Summary

Introduction

Obesity and its various comorbidities currently comprise the most serious, most prevalent, and most challenging health concerns worldwide [1, 2]. For patients with severe obesity, high body mass indexes (BMIs), serious comorbidities, and extremely poor qualities of life, bariatric (weight loss) surgery can provide a substantial health benefit despite the operative risks [3]. The restrictive and metabolic effects of LSG result from the vertical resection of a large portion of the stomach, including the fundus [5,6,7,8]. These resection specimens are the sources for vast amounts of published data on histopathological changes in patients from developed countries and may provide a basis for monitoring long- and short-term effects of the operation. It is highly advised that bariatric/metabolic surgeons collect these specimens to provide further data on LSG

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Conclusion