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Open Access 24-02-2024 | Helicobacter Pylori | Original Contributions

Effects of Preoperative Quadruple Therapy for Helicobacter pylori on Bariatric Surgery Metabolic Outcomes

Authors: Albert Goday, Andrea Bagán, Anna Casajoana, Carme Serra, Manuel Pera, Montserrat Villatoro, Teresa Legido, Helena Julià, Elisenda Climent, Olga Castañer, Juana A Flores Le Roux, Miguel Olano, Juan Pedro-Botet, David Benaiges

Published in: Obesity Surgery | Issue 4/2024

Abstract

Purpose

To assess the effects of Helicobacter pylori (HP) eradication with an omeprazole, clarithromycin, amoxicillin, and metronidazole (OCAM) regimen on the metabolic profile and weight loss 12 months after bariatric surgery (BS).

Methods

Retrospective analysis of a prospective cohort of patients with morbid obesity undergoing BS. HP presence was tested preoperatively by gastric biopsy and treated with OCAM when positive. Short-term metabolic outcomes and weight loss were evaluated.

Results

HP infection was detected in 75 (45.7%) of the 164 patients included. OCAM effectiveness was 90.1%. HP-negative patients had a greater reduction in glucose levels at 3 (−14.6 ± 27.5 mg/dL HP-treated vs −22.0 ± 37.1 mg/dL HP-negative, p=0.045) and 6 months (−13.7 ± 29.4 mg/dL HP-treated vs −26.4 ± 42.6 mg/dL HP-negative, p= 0.021) and greater total weight loss (%TWL) at 6 (28.7 ± 6.7% HP-treated vs 30.45 ± 6.48% HP-negative, p= 0.04) and 12 months (32.21 ± 8.11% HP-treated vs 35.14 ± 8.63% HP-negative, p= 0.023).

Conclusions

Preoperative treatment with OCAM has been associated to poorer glycemic and weight loss outcomes after BS. More research is needed on the influence of OCAM on gut microbiota, and in turn, the effect of the latter on metabolic and weight loss outcomes after BS.

Graphical Abstract

Picot J, Jones J, Colquitt JL, et al. The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity Executive summar. Health Technol Assess (Rockv). 2009;13:1–190.

Colquitt JL, Picot J, Loveman E, et al. Surgery for obesity. Cochrane Database Syst Rev. 2009:CD003641.

Buchwald H. The evolution of metabolic/bariatric surgery. Obes Surg. 2014;24:1126–35.CrossRefPubMed

Shi Q, Wang Q, Zhong H, et al. Roux-en-Y gastric bypass improved insulin resistance via alteration of the human gut microbiome and alleviation of endotoxemia. Biomed Res Int. 2021;2021:1–14.

Dang JT, Mocanu V, Park H, et al. Ileal microbial shifts after Roux-en-Y gastric bypass orchestrate changes in glucose metabolism through modulation of bile acids and L-cell adaptation. Sci Rep. 2021;11:23813.CrossRefPubMedPubMedCentral

Di Palma A, Alhabdan S, Maeda A, et al. Preoperative Helicobacter pylori screening and treatment in patients undergoing laparoscopic sleeve gastrectomy. Obes Surg. 2020;30:2816–20.CrossRefPubMed

Mocanu V, Dang JT, Switzer N, et al. The effect of Helicobacter pylori on postoperative outcomes in patients undergoing bariatric surgery: a systematic review and meta-analysis. Obes Surg. 2018;28:567–73.CrossRefPubMed

Serin KR, Akyüz Ü, Batman B, et al.. Does Helicobacter pylori infection influence the major postoperative complication rate after sleeve gastrectomy? A retrospective cohort study in an endemic region. 2018CrossRef

Goday A, Castañer O, Benaiges D, et al. Can Helicobacter pylori eradication treatment modify the metabolic response to bariatric surgery? Obes Surg. 2018;28:2386–95.CrossRefPubMed

10.

Graham DY, Fischbach L. Helicobacter pylori treatment in the era of increasing antibiotic resistance. Gut. 2010;59:1143–53.CrossRefPubMed

11.

Cerqueira RM, Correia M, Vilar H, et al. Cumulative Helicobacter pylori eradication rates by adopting first- and second- line regimens proposed by the Maastricht IV Consensus in obese patients undergoing gastric bypass surgery. Obes Surg. 28:743–7.

12.

Laudanno O, Ahumarán G, Gollo P, et al. Tailored Helicobacter pylori eradication therapy in obese patients undergoing bariatric surgery. Revista Espanola de Enfermedades Digestivas. 2021;113:345–7.PubMed

13.

Gastrointestinal surgery for severe obesity. Proceedings of a National Institutes of Health Consensus Development Conference. March 25-27, 1991, Bethesda, MD. Am J Clin Nutr. 1992;55:487S–619S.

14.

Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–9

15.

Cho YS, Chae HS, Jang SN, et al. Comparison of the 13C-urea breath test and the endoscopic phenol red mucosal pH test in the quantification of Helicobacter pylori infection loading. Korean J Intern Med. 2008;23:134.CrossRefPubMedPubMedCentral

16.

Gisbert JP, Boixeda D, Redondo C, et al. Breath test in the diagnosis of Helicobacter pylori infection: concordance with histological methods and correlation with anatomopathological lesions of the gastric mucosa. Rev Esp Enferm Dig. 1996;88:259–64.PubMed

17.

Roma-Giannikou E, Roubani A, Sgouras DN, et al. Endoscopic tests for the diagnosis of Helicobacter pylori infection in children: validation of rapid urease test. Helicobacter. 2010;15:227–32.CrossRefPubMed

18.

Taniguchi Y, Kimura K, Sohara H, et al. Simple 13C-urea breath test with infra-red spectrophotometer. J Gastroenterol. 1996;31(Suppl 9):37–40.PubMed

19.

Benaiges D, Goday A, Ramon JM, et al. Laparoscopic sleeve gastrectomy and laparoscopic gastric bypass are equally effective for reduction of cardiovascular risk in severely obese patients at one year of follow-up. Surg Obes Related Dis. 2011;7:575–80.CrossRef

20.

Fontané L, Benaiges D, Goday A, et al. Influencia de la microbiota y de los probióticos en la obesidad. Clínica e Investigación en Arteriosclerosis. 2018;30:271–9.CrossRefPubMed

21.

Jacobson R, Terranella S, Booker C, et al. The impact of perioperative antibiotic prophylaxis on weight loss following laparoscopic sleeve gastrectomy. J Laparoendosc Adv Surg Tech. 2020;30(9):998–1000.CrossRef

22.

Rodrigues RR, Greer RL, Dong X, et al. Antibiotic-induced alterations in gut microbiota are associated with changes in glucose metabolism in healthy mice. Front Microbiol. 2017;8:2306.CrossRefPubMedPubMedCentral

23.

Bäckhed F, Ding H, Wang T, et al. The gut microbiota as an environmental factor that regulates fat storage. Proc Natl Acad Sci U S A. 2004;101:15718–23.CrossRefPubMedPubMedCentral

24.

Cani PD, Amar J, Iglesias MA, et al. Metabolic endotoxemia initiates obesity and insulin resistance. Diabetes. 2007;56:1761–72.CrossRefPubMed

25.

Gutiérrez-Repiso C, Moreno-Indias I, et al. Influence of factors altering gastric microbiota on bariatric surgery metabolic outcomes. Microbiol Spectr. 2021;9(3):e00535-21.CrossRefPubMedPubMedCentral

26.

Salminen P, Helmio M, Ovaska J, et al. Effect of laparoscopic sleeve gastrectomy vs laparoscopic roux-en-y gastric bypass onweight loss at 5 years among patients with morbid obesity the SLEEVEPASS randomized clinical trial. JAMA –J Am Med Assoc. 2018;319:241–254.

27.

Benotti PN, Still CD, Wood GC, et al. Preoperative weight loss before bariatric surgery. Arch Surg. 2009;144:1150.CrossRefPubMedPubMedCentral

28.

Bouchard DR, Baillargeon JP, Langlois MF. The independent effect of age groups on the effectiveness of lifestyle intervention. Curr Obes Rep. 2013;2:107–19.CrossRef

29.

Mestrovic A, Perkovic N, Bozic J, et al. Randomised clinical trial comparing concomitant and hybrid therapy for eradication of Helicobacter pylori infection. PLoS One. 2020;15:e0244500.CrossRefPubMedPubMedCentral

30.

Yoon K, Kim N. Eradication rates of 10-day sequential therapy for Helicobacter pylori: results of an 8-year prospective study conducted at a tertiary Korean hospital. Korean J Gastroenterol. 2019;73:99–104.CrossRefPubMed

31.

Espada M, Nyssen OPGJP. Non-bismuth quadruple concomitant treatment for H. pylori eradication: systematic review and meta-analysis. United European Gastroenterol J. 2021;9:325.

32.

Cerqueira RM, Correia MR, Vilar H, et al. How effective is the quadruple concomitant Helicobacter pylori eradication therapy for obese patients undergoing gastric bypass surgery? Obes Surg. 2016;26:1163–6.CrossRefPubMed

Title: Effects of Preoperative Quadruple Therapy for Helicobacter pylori on Bariatric Surgery Metabolic Outcomes
Authors: Albert Goday
Andrea Bagán
Anna Casajoana
Carme Serra
Manuel Pera
Montserrat Villatoro
Teresa Legido
Helena Julià
Elisenda Climent
Olga Castañer
Juana A Flores Le Roux
Miguel Olano
Juan Pedro-Botet
David Benaiges
Publication date: 24-02-2024
Publisher: Springer US
Keywords: Helicobacter Pylori
Bariatric Surgery
Bariatric Surgery
Sleeve Gastrectomy
Obesity
Obesity
Metronidazole
Respiratory Microbiota
Omeprazole
Published in: Obesity Surgery / Issue 4/2024
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-024-07091-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effects of Preoperative Quadruple Therapy for Helicobacter pylori on Bariatric Surgery Metabolic Outcomes

Abstract

Purpose

Methods

Results

Conclusions

Graphical Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Graphical Abstract

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