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Response

      We thank Kountouras et al
      • Kountouras J.
      • Doulberis M.
      • Polyzos S.A.
      A potential impact of Helicobacter pylori-related metabolic syndrome on early and long-term outcomes of bariatric surgery.
      for their interest in and comment on our study.
      • Alqahtani A.R.
      • Elahmedi M.
      • Aldarwish A.
      • et al.
      Endoscopic gastroplasty versus laparoscopic sleeve gastrectomy: a noninferiority propensity score-matched comparative study.
      We understand and appreciate the authors’ opinion with regard to Helicobacter pylori–related metabolic syndrome and the fact that H pylori infection is common in patients with obesity. A sample of 227 patients who underwent EGD before bariatric surgery found H pylori in 27% of patiets.
      • Ashour H.
      • Khurshid A.
      • Almalki O.
      • et al.
      Role of upper gastrointestinal endoscopy before bariatric surgery.
      Several studies have suggested that H pylori does not affect laparoscopic sleeve gastrectomy (LSG) perioperative outcomes or postoperative weight loss.
      • Rossetti G.
      • Moccia F.
      • Marra T.
      • et al.
      Does helicobacter pylori infection have influence on outcome of laparoscopic sleeve gastrectomy for morbid obesity?.
      Additionally, a large study by Abu Abeid et al
      • Abu Abeid A.
      • Abeid S.A.
      • Nizri E.
      • et al.
      The association of Helicobacter pylori eradication, and early complications of laparoscopic sleeve gastrectomy.
      showed that H pylori eradication does not change the postoperative course. However, LSG may lead to eradication of H pylori.
      • Keren D.
      • Matter I.
      • Rainis T.
      • et al.
      Sleeve gastrectomy leads to Helicobacter pylori eradication.
      For those reasons, we believe that assessing for the presence of H pylori in asymptomatic candidates before LSG is unnecessary and would only add cost and patient discomfort. It is also worth noting that the American Society for Metabolic and Bariatric Surgery care pathway for LSG states that H pylori testing should be performed only at the discretion of the provider and based on patient history.
      • Telem D.A.
      • Gould J.
      • Pesta C.
      • et al.
      American Society for Metabolic and Bariatric Surgery: care pathway for laparoscopic sleeve gastrectomy.
      Accordingly, our propensity score–matched comparative study did not assess H pylori before or after LSG or endoscopic sleeve gastroplasty.
      • Alqahtani A.R.
      • Elahmedi M.
      • Aldarwish A.
      • et al.
      Endoscopic gastroplasty versus laparoscopic sleeve gastrectomy: a noninferiority propensity score-matched comparative study.
      Further studies are warranted before a conclusion can be drawn regarding H pylori testing in patients undergoing endoscopic gastroplasty.

      Disclosure

      The author disclosed no financial relationships.

      References

        • Kountouras J.
        • Doulberis M.
        • Polyzos S.A.
        A potential impact of Helicobacter pylori-related metabolic syndrome on early and long-term outcomes of bariatric surgery.
        Gastrointest Endosc. 2022; 96: 1088-1089
        • Alqahtani A.R.
        • Elahmedi M.
        • Aldarwish A.
        • et al.
        Endoscopic gastroplasty versus laparoscopic sleeve gastrectomy: a noninferiority propensity score-matched comparative study.
        Gastrointest Endosc. 2022; 96: 44-50
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        • Khurshid A.
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        Role of upper gastrointestinal endoscopy before bariatric surgery.
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        • Marra T.
        • et al.
        Does helicobacter pylori infection have influence on outcome of laparoscopic sleeve gastrectomy for morbid obesity?.
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        The association of Helicobacter pylori eradication, and early complications of laparoscopic sleeve gastrectomy.
        Obes Surg. 2022; 32: 1617-1623
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        Sleeve gastrectomy leads to Helicobacter pylori eradication.
        Obes Surg. 2009; 19: 751-756
        • Telem D.A.
        • Gould J.
        • Pesta C.
        • et al.
        American Society for Metabolic and Bariatric Surgery: care pathway for laparoscopic sleeve gastrectomy.
        Surg Obes Relat Dis. 2017; 13: 742-749

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