43. THE PATHOLOGY OF GASTRIC SLEEVE RESECTIONS FOR WEIGHT LOSS. (February 2015)

• Record Type: Journal Article
• Authors: Reid, Andrew; Miller, Gregory; Brown, Ian
• Is Part Of: Pathology. Volume 47(2015)Supplement 1
• Publication Date: 2015-02
• Subjects: Pathology -- Periodicals; 616.0705
• DOI: 10.1097/01.PAT.0000461652.48104.bd
• Languages: English
• ISSNs: 0031-3025

Abstract

Abstract : Background: As a treatment for morbid obesity, the number of sleeve gastrectomy operations performed has increased markedly over the last five years. Patients undergoing this operation usually have minimal or no preoperative gastric investigations. There is scant data available on the pathology seen sleeve gastrectomy specimens and whether pre-operative investigations would be warranted to ensure serious disorders are managed appropriately. Aims: To determine the frequency of various pathologies present in gastric sleeve bypass specimens. Methods: A retrospective analysis of a consecutive series of sleeve gastrectomies, performed for weight loss, was conducted. The specimens were collected from both a Private (586 cases) and Public (214 cases) Pathology Service between 2000 and 2014. Results and conclusions: The series included 800 sequential cases and 74% were female. Abnormal findings were seen in 203 cases (25.4%). The most commonly seen pathology was non-specific, non-Helicobacter associated gastritis (86 cases, 10.75%). Helicobacter associated gastritis was seen in 53 cases (6.3%). Other common pathologic findings were benign polyps (fundic gland polyps and hyperplastic polyps) in 37 cases, proton pump inhibitor changes in 7 cases, and lymphocytic gastritis pattern of inflammation in 7 cases. There were also rare examples of autoimmune gastritis, gastrointestinal stromal tumour, pancreatic heterotopia, gastric atrophy, vascular ectasia and a sarcoma. This series has shown that the vast majority of sleeve gastrectomies show either normal histology or benign changes. Based on this series, it would appear that the use of pre-operative investigations is unwarranted.