Obezite Cerrahisi Sonrası Helicobacter pylori Enfeksiyonunun Spontan Eliminasyonu: Sleeve Gastrektomi Etkisi

Aim: This study aimed to evaluate the spontaneous postoperative negativization rate of preoperative Helicobacter pylori (H. pylori) positivity in obese patients undergoing sleeve gastrectomy, without any eradication therapy.Materials: Twenty-three patients who underwent primary laparoscopic sleeve gastrectomy between 2020 and 2024 were included. Preoperative H. pylori positivity was confirmed by histology, rapid urease test, urea breath test, or stool antigen test. H. pylori status was reassessed at 6 and 12 months postoperatively. Demographic, metabolic, and endoscopic data were recorded. Spontaneous elimination was defined as a negative test confirmed by two different diagnostic methods.Results: At 12 months, 12 patients were H. pylori-negative, with a total spontaneous elimination rate of 52.2%. Transient negativization at 6 months was 45.0%. The mean gastritis score was 2.1 ± 0.6 in patients who became negative versus 3.0 ± 0.7 in those who remained positive (p = 0.012). HOMA-IR decreased from 4.9 ± 2.3 to 2.6 ± 1.4 (p < 0.001). Significant reductions in total cholesterol, LDL, and triglycerides, and an increase in HDL were observed (p < 0.05). All three patients who developed ulcers remained H. pylori-positive (p = 0.037).Conclusion: After sleeve gastrectomy, H. pylori may spontaneously disappear in a substantial proportion of patients without eradication therapy, associated with metabolic improvement. Postoperative monitoring and standard test confirmation are important for patient safety and effective antibiotic stewardship.