Abstract
INTRODUCTION: Bariatric surgery has become one of the most prominent treatment modalities for obesity. Esophagogastroscopy (EGD) with Helicobacter pylori testing is a part of the preoperative work-up. There are no guidelines defining the preferred method of detecting H. pylori. AIM: The study aimed to establish the prevalence of H. pylori infection among bariatric patients and compare the two commonly used invasive diagnostic tests: the rapid urease test (RUT) and histopathology. The secondary aim was to evaluate the usefulness of EGD and histology in diagnosing gastritis. MATERIAL AND METHODS: A retrospective analysis was performed among patients with obesity undergoing bariatric surgery. As part of the preoperative work-up, EGD was performed with RUT using the Lencomm GOLD Hp dry CLO test and a histopathology sample taken from the gastric antrum and body. The Cohen's kappa inter-rated reliability test was used for concordance calculation. RESULTS: 280 patients were analyzed, of whom 98 (35.00%) were diagnosed with H. pylori infection with at least one method. The Cohen's kappa inter-rated agreement between the RUT and histology sampling was 0.80. Macroscopic gastritis was present in 76 (77.56%) of infected patients. Histology showed microscopic gastritis in 99 (99%) of those patients. 161 (57.50%) of the study group were diagnosed with macroscopic gastritis; among these, histology confirmed inflammation in 119 (73.91%). CONCLUSIONS: There is a good concordance between RUT and histopathology diagnosis of H. pylori among the bariatric population. Additionally, there is a low accuracy rate in EGD assessments of gastric mucosa changes.