The Impact of Helicobacter pylori on Marginal Ulcer Formation Following Gastric Bypass: A Systematic Review and Meta-Analysis.

Abstract

Roux-en-Y gastric bypass (RYGB) is one of the most commonly performed bariatric procedures worldwide and is highly effective in improving obesity-related comorbidities; however, marginal ulceration remains a recognised postoperative complication. <i>Helicobacter pylori</i> (HP), a known risk factor for peptic ulcer disease, has an uncertain role in marginal ulcer formation following RYGB. This systematic review and meta-analysis aimed to clarify whether preoperative HP infection increases the risk of marginal ulcer development. A systematic search of PubMed, Embase, and Cochrane databases identified 119 studies, of which seven met inclusion criteria, encompassing 255,899 patients (mean age 42.8 years, mean BMI 47.3 kg/m²). Pooled analysis using a random-effects model demonstrated no significant association between HP infection and marginal ulcer incidence after RYGB (risk ratio = 1.16, 95 % CI 0.23-5.88, p = 0.86), with substantial heterogeneity among studies (I² = 96.4 %, p < 0.0001). These findings suggest that preoperative HP infection does not significantly influence the risk of marginal ulcer formation following RYGB.