Histopathologic Findings in Sleeve Gastrectomy Specimens: Is Routine Pathological Examination Always Necessary?

TL;DR

This study examines histopathological findings in sleeve gastrectomy samples and finds that routine post-surgery pathology exams often reveal significant abnormalities not predicted by pre-surgery tests.

Contribution

The study highlights the high prevalence of postoperative histopathological changes not captured by preoperative endoscopic evaluations.

Findings

82.2% of sleeve gastrectomy samples showed pathological findings, with chronic gastritis being the most common.

Helicobacter pylori infection was present in 19.0% of patients and linked to hyperlipidemia.

Preoperative endoscopic results did not reliably predict postoperative histopathological changes.

Abstract

There are limited findings regarding histopathological changes in sleeve gastrectomy samples and their relationship with preoperative clinical and histopathological characteristics. The present study aims to assess histopathological findings in sleeve gastrectomy samples and identify the main determinants of these changes.

This cross-sectional study retrospectively reviewed demographic, preoperative clinical, histological, and endoscopic findings of 258 patients who underwent laparoscopic sleeve gastrectomy surgery. Postoperative pathological findings were also evaluated.

Microscopic examination revealed pathological findings in 212 samples (82.2%). The most common histopathological finding reported in patients was chronic gastritis, present in approximately 67.1% of cases, followed by active gastritis in 13.6%. Additionally, 19.0% of patients tested positive for helicobacter pylori infection. A significant association was found between the history of hyperlipidemia and helicobacter pylori positivity (p = 0.039). Before surgery, 80 patients (41.7%) had normal endoscopic results, while at least one significant abnormal finding was observed in 58.3% of cases. However, there was no significant relationship between preoperative endoscopic findings and histopathological changes after surgery in almost all examined patients.

Histopathological examination of sleeve gastrectomy samples reveals a high prevalence of abnormal findings, including active gastritis, Helicobacter pylori infection, intestinal metaplasia, and dysplasia requiring therapeutic management. However, tracking these changes in biopsy samples obtained from endoscopy before surgery may not be sufficient to predict the histopathological findings after sleeve gastrectomy.