幽门螺杆菌感染对代谢和减重手术并发症的影响：一项系统评价和荟萃分析
Effect of Helicobacter pylori infection on metabolic and bariatric surgical complications: a systematic review and meta-analysis.
作者信息
Kermansaravi Mohammad, Valizadeh Rohollah, ShahabiShahmiri Shahab, Zakeri Roxanna, Safari Saeed, Eghbali Foolad, Farazmand Behnood, Shahsavan Masoumeh, DavarpanahJazi Amirhossen, Pouwels Sjaak
机构信息
Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Hazrat-E Fatemeh Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Center of Excellence of European Branch of International Federation for Surgery of Obesity, Hazrat_e Rasool Hospital, Tehran, Iran.
出版信息
Updates Surg. 2025 Mar 25. doi: 10.1007/s13304-025-02151-y.
More papers have discussed the importance of preoperative detection and eradication of Helicobacter pylori (HP) in patients before and after Metabolic and Bariatric Surgery (MBS). This systematic review and meta-analysis aimed to evaluate the role of preoperative H. pylori eradication vs non-treatment in the development of post-op complications in the setting of bariatric and metabolic surgery. This study aimed to evaluate the effect of Helicobacter pylori (HP) on metabolic and bariatric surgical complications through a systematic review and meta-analysis. A systematic search on the influence of HP infection on postoperative complications in bariatric surgery was conducted. The methodological quality of the included studies was rated using the Newcastle-Ottawa Rating scale. In case of consistent reporting of the data, a meta-analysis was performed. A total of 19 studies containing 261,186 patients were included. The mean age of the patients was 41.88 ± 7.40 years with a mean BMI of 45.53 ± 3.16 kg/m. The mean follow-up was 21.72 months (range: 1-96 months). Testing for HP infections was often done using an esophagogastroduodenoscopy in combination with biopsy (42%). A urea breath test (59%) was the most common tool to confirm eradication. To eradicate HP, 2 weeks of PPI with antibiotics, 1 week of PPI with antibiotics, and PPI alone without antibiotics were used in 18 (67%), 3 (11%), and 6 (22%) studies, respectively. The prevalence of complications among patients with positive/negative HP was not significantly different (P > 0.05). In HP patients without preoperative eradication, odds ratio of bleeding was 1.48 (95% CI 0.80-2.73), ulcer was 6.88 (95% CI 5.60-8.45), leakage was 1.73 (95% CI 0.81-3.68), stricture was 1.13 (95% CI 0.30-4.21), and abscesses was 3.01 (95% CI 0.85-10.65). Helicobacter pylori infection is associated with potential postoperative complications, and therefore, it needs adequate treatment.
越来越多的论文讨论了在代谢和减重手术（MBS）前后对患者进行术前幽门螺杆菌（HP）检测和根除的重要性。本系统评价和荟萃分析旨在评估术前根除幽门螺杆菌与不治疗在减重和代谢手术中术后并发症发生方面的作用。本研究旨在通过系统评价和荟萃分析评估幽门螺杆菌（HP）对代谢和减重手术并发症的影响。对HP感染对减重手术术后并发症的影响进行了系统检索。使用纽卡斯尔-渥太华评分量表对纳入研究的方法学质量进行评分。如果数据报告一致，则进行荟萃分析。共纳入19项研究，包含261,186例患者。患者的平均年龄为41.88±7.40岁，平均体重指数为45.53±3.16kg/m²。平均随访时间为21.72个月（范围：1 - 96个月）。HP感染检测通常采用食管胃十二指肠镜检查联合活检（42%）。尿素呼气试验（59%）是确认根除的最常用工具。为根除HP，18项（67%）、3项（11%）和6项（22%）研究分别使用了2周质子泵抑制剂联合抗生素、1周质子泵抑制剂联合抗生素以及单独使用质子泵抑制剂而不使用抗生素。HP阳性/阴性患者并发症的发生率无显著差异（P>0.05）。在未进行术前根除的HP患者中，出血的比值比为1.48（95%可信区间0.80 - 2.73），溃疡为6.88（95%可信区间5.60 - 8.45），渗漏为1.73（95%可信区间0.81 - 3.68），狭窄为1.13（95%可信区间0.30 - 4.21），脓肿为3.01（95%可信区间0.85 - 10.65）。幽门螺杆菌感染与潜在的术后并发症相关，因此，需要进行充分治疗。
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