Gastric histopathologies in patients undergoing laparoscopic sleeve gastrectomies

BACKGROUND

With 80 % of its population overweight, 47.5 % obese, and having the eighth fattest population worldwide, Kuwait has a serious obesity problem. This has led to widespread practice of bariatric surgery, with little or no studies regarding operative findings and patient follow-up. This study aims to identify the prevalent gastric histopathologies of the patients who have undergone laparoscopic sleeve gastrectomy (LSG) at Amiri Hospital, Kuwait.

METHODS

A retrospective study was done of the gastric pathology specimen results of 656 patients who underwent LSG at Amiri Hospital from 2008 to 2012.

RESULTS

Of the 656 patients, the average age was 33 years, and 480 (73.2 %) were female while 176 (26.8 %) were male. The histopathology results identified 488 (74.4 %) cases with chronic gastritis, 63 (9.6 %) with follicular gastritis, and 12 (1.8 %) with atrophic gastritis. A total of 12 (1.8 %) cases showed findings other than gastritis, including four (0.6 %) cases of gastric polyps, three (0.5 %) cases of granulomatous disease, and one (0.2 %) case each of the following: gastro-intestinal stromal tumor, gastro-intestinal autonomic nerve tumor, intestinal metaplasia, collagenous gastritis, and crypt cell apoptosis. Helicobacter pylori was discovered in 48 (7.3 %) of the patients.

CONCLUSIONS

The majority of gastric histopathology results after LSG in this study had an element of chronic gastritis (74.4 %), which is in keeping with previous studies showing its high prevalence among the obese population. However, a few cases had clinically significant pathologies, and this may alter post-operative management. In view of these results, routine histological examination of the gastric specimens is highly recommended.

Primary hepatic carcinoid tumor

OBJECTIVES

To describe a rare case of primary carcinoid tumor of the liver and its management.

CLINICAL PRESENTATION AND INTERVENTIONS

A 44-year-old Nigerian male presented with a big inoperable liver mass, which proved to be a carcinoid tumor by fine needle aspiration cytology. Extensive search for a primary lesion including laparotomy and peroperative ultrasound failed to find a primary lesion in the gastrointestinal tract and pancreas. Percutaneous embolization of the tumor followed by complete dearterializations of the liver seemed to have halted the growth of the tumor. The patient remained well with normal liver function tests for 56 months when he decided to go back to his country.

CONCLUSION

The result showed that dearterializations of a primary inoperable carcinoid of the liver offered good palliation.