{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T00:20:25Z","timestamp":1755217225388,"version":"3.43.0"},"reference-count":30,"publisher":"King Faisal Specialist Hospital and Research Centre","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Saudi Med"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Metabolic and bariatric surgeries are effective interventions in reducing weight and mortality. Laparoscopic sleeve gastrectomy is the most commonly performed procedure, particularly in the Middle East and North Africa (MENA) region. It involves resection of approximately 80% of the stomach, yielding large specimens for histopathological evaluation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>OBJECTIVES:<\/jats:title>\n            <jats:p>To identify histopathological findings in gastric specimens, evaluate the incidence of unexpected gastrointestinal stromal tumors (GISTs), and characterize the metabolic and bariatric surgery population in Saudi Arabia.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>DESIGN:<\/jats:title>\n            <jats:p>Retrospective cohort<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>SETTINGS:<\/jats:title>\n            <jats:p>Single-center tertiary care in Saudi Arabia<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>PATIENTS AND METHODS:<\/jats:title>\n            <jats:p>\n              The study included patients who underwent laparoscopic gastric sleeve between May 2015 and April 2021. Inclusion criteria were patients with BMI \u2265 30 kg\/m\n              <jats:sup>2<\/jats:sup>\n              who underwent surgery as treatment for obesity.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>MAIN OUTCOME MEASURES:<\/jats:title>\n            <jats:p>Gastric histopathological findings, unexpected GIST incidence and metabolic and bariatric surgery population.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>SAMPLE SIZE:<\/jats:title>\n            <jats:p>211 patients with obesity<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              Patients' mean age was 38.2 years with a mean Body mass index (BMI) of 44.24 kg\/m\n              <jats:sup>2<\/jats:sup>\n              . The majority were females (60.2%). Normal histology findings accounted for 43.1% of findings, followed by chronic inactive gastritis (35.5%). Intestinal metaplasia was found in 1 (0.5%) patient while incidental GIST was found in 2 (0.9%) patients.\n              <jats:italic toggle=\"yes\">Helicobacter pylori (H. pylori)<\/jats:italic>\n              was identified in 12.8% of cases, with a mean patient age of 36.7 years. Among\n              <jats:italic toggle=\"yes\">H. pylori<\/jats:italic>\n              -positive patients, 48% presented with chronic active gastritis, 33% with chronic inactive gastritis, 14.8% with active follicular gastritis, and 3.7% with inactive follicular gastritis. A history of prior endoscopy was noted in 16.1% of patients, of whom 11.76% were found to have\n              <jats:italic toggle=\"yes\">H. pylori<\/jats:italic>\n              postoperatively.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>\n              H. pylori infection was detected at a mean age of 36.7 years and showed a significant association with higher BMI (mean difference: 2.2 kg\/m\n              <jats:sup>2<\/jats:sup>\n              ,\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =.04). While this suggests a potential link between obesity and\n              <jats:italic toggle=\"yes\">H. pylori<\/jats:italic>\n              susceptibility, the clinical significance of this small absolute difference requires further investigation.\n              <jats:italic toggle=\"yes\">H. pylori<\/jats:italic>\n              remained strongly associated with follicular gastritis (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =.003) but showed no difference between males and females.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>LIMITATIONS:<\/jats:title>\n            <jats:p>\n              Retrospective design and Giemsa stain was not done for all specimens to investigate\n              <jats:italic toggle=\"yes\">H. pylori<\/jats:italic>\n              .\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.5144\/0256-4947.2025.218","type":"journal-article","created":{"date-parts":[[2025,8,3]],"date-time":"2025-08-03T06:14:46Z","timestamp":1754201686000},"page":"218-224","source":"Crossref","is-referenced-by-count":0,"title":["Histopathological findings in obese patients undergoing laparoscopic sleeve gastrectomy in the Western region of Saudi Arabia"],"prefix":"10.5144","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6351-7187","authenticated-orcid":true,"given":"Samah","family":"Saharti","sequence":"first","affiliation":[{"name":"From the Department of Pathology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reem","family":"Aljohani","sequence":"additional","affiliation":[{"name":"From the Department of Pathology, Temple University Hospital, Philadelphia, Pennsylvannia, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3134","reference":[{"key":"e_1_3_2_2_2","unstructured":"World Health Organization [Internet]. 2020 [cited 2021 Feb 13]. Obesity and overweight. Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/obesity-and-overweight"},{"key":"e_1_3_2_3_2","unstructured":"ProCon.org [Internet]. 2020 [cited 2021 Feb 13]. Global Obesity Levels - Obesity - ProCon.org. Available from: https:\/\/obesity.procon.org\/global-obesity-levels\/"},{"issue":"6","key":"e_1_3_2_4_2","doi-asserted-by":"crossref","first-page":"e12400","DOI":"10.1111\/cob.12400","article-title":"Prevalence and social determinants of overweight and obesity in adolescents in Saudi Arabia: A systematic review","volume":"10","author":"Habbab RM","year":"2020","unstructured":"Habbab RM, Bhutta ZA. Prevalence and social determinants of overweight and obesity in adolescents in Saudi Arabia: A systematic review. Clin Obes. 2020 Dec;10(6):e12400.","journal-title":"Clin Obes"},{"issue":"02","key":"e_1_3_2_5_2","article-title":"A Review of Prevalence of Obesity in Saudi Arabia","volume":"02","author":"Alqarni SS","year":"2016","unstructured":"Alqarni SS. A Review of Prevalence of Obesity in Saudi Arabia. J Obes Eat Disord [Internet]. 2016 [cited 2023 Dec 23];02(02). Available from: http:\/\/obesity.imedpub.com\/a-review-of-prevalence-of-obesity-in-saudi-arabia.php?aid=17699.","journal-title":"J Obes Eat Disord [Internet]"},{"issue":"1","key":"e_1_3_2_6_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4103\/2347-2618.184930","article-title":"Bariatric surgery in Saudi Arabia: The urgent need for standards","volume":"4","author":"AAl-Khaldi Y","year":"2016","unstructured":"AAl-Khaldi Y. Bariatric surgery in Saudi Arabia: The urgent need for standards. Saudi J Obesity. 2016;4(1):1.","journal-title":"Saudi J Obesity"},{"issue":"11","key":"e_1_3_2_7_2","doi-asserted-by":"crossref","first-page":"1844","DOI":"10.1161\/CIRCRESAHA.116.307591","article-title":"Treatment of Obesity: Weight Loss and Bariatric Surgery","volume":"118","author":"Wolfe BM","year":"2016","unstructured":"Wolfe BM, Kvach E, Eckel RH. Treatment of Obesity: Weight Loss and Bariatric Surgery. Circ Res. 2016 May;118(11):1844\u201355.","journal-title":"Circ Res"},{"issue":"1","key":"e_1_3_2_8_2","doi-asserted-by":"crossref","first-page":"18","DOI":"10.4103\/2347-2618.119472","article-title":"Management of obesity: Saudi Clinical Guideline","volume":"1","author":"Al-Shehri F","year":"2013","unstructured":"Al-Shehri F, Moqbel M, Al-Shahrani A, Al-Khaldi Y, Abu-Melha W. Management of obesity: Saudi Clinical Guideline. Saudi J Obesity. 2013;1(1):18.","journal-title":"Saudi J Obesity"},{"key":"e_1_3_2_9_2","volume-title":"The International Federation for the Surgery of Obesity and Metabolic Disorders Fifth IFSO Global Registry Report 2019","author":"Almino Ramos L","year":"2019","unstructured":"Almino Ramos L, Kow W, Brown W, Welbourn R, Dixon J, Kinsman R, et al. The International Federation for the Surgery of Obesity and Metabolic Disorders Fifth IFSO Global Registry Report 2019 [Internet]. The IFSO Global Registry; 2019. Available from: https:\/\/www.ifso.com\/pdf\/5th-ifso-global-registry-report-september-2019.pdf."},{"issue":"4","key":"e_1_3_2_10_2","doi-asserted-by":"crossref","first-page":"502","DOI":"10.4293\/108680810X12924466007809","article-title":"Laparoscopic sleeve gastrectomy: our first 100 patients","volume":"14","author":"Nath A","year":"2010","unstructured":"Nath A, Leblanc KA, Hausmann MG, Kleinpeter K, Allain BW, Romero R. Laparoscopic sleeve gastrectomy: our first 100 patients. JSLS. 2010;14(4):502\u20138.","journal-title":"JSLS"},{"issue":"3","key":"e_1_3_2_11_2","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1007\/s11695-015-1801-9","article-title":"Spectrum of Gastric Histopathologies in Severely Obese American Patients Undergoing Sleeve Gastrectomy","volume":"26","author":"Ohanessian SE","year":"2016","unstructured":"Ohanessian SE, Rogers AM, Karamchandani DM. Spectrum of Gastric Histopathologies in Severely Obese American Patients Undergoing Sleeve Gastrectomy. Obes Surg. 2016;26(3):595\u2013602.","journal-title":"Obes Surg"},{"key":"e_1_3_2_12_2","first-page":"1702705","article-title":"Histopathological Findings in Laparoscopic Sleeve Gastrectomy Specimens from Patients with Obesity in Saudi Arabia","author":"Aljerian K","year":"2018","unstructured":"Aljerian K. Histopathological Findings in Laparoscopic Sleeve Gastrectomy Specimens from Patients with Obesity in Saudi Arabia. Gastroenterol Res Pract. 2018;2018:1702705.","journal-title":"Gastroenterol Res Pract"},{"issue":"1","key":"e_1_3_2_13_2","doi-asserted-by":"crossref","first-page":"1786","DOI":"10.19082\/1786","article-title":"Chronic gastritis in morbidly obese patients with sleeve gastrectomy","volume":"8","author":"Makki AM","year":"2016","unstructured":"Makki AM, Aldaqal SM, Alorabi SH, Nemri AI, Alajami MM. Chronic gastritis in morbidly obese patients with sleeve gastrectomy. Electron Physician. 2016 Jan 15;8(1):1786\u201390.","journal-title":"Electron Physician"},{"issue":"5","key":"e_1_3_2_14_2","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1177\/1557988314567223","article-title":"Gender Differences in Weight-Related Attitudes and Behaviors Among Overweight and Obese Adults in the United States","volume":"10","author":"Tsai SA","year":"2016","unstructured":"Tsai SA, Lv N, Xiao L, Ma J. Gender Differences in Weight-Related Attitudes and Behaviors Among Overweight and Obese Adults in the United States. Am J Men's Health. 2016;10(5):389\u201398.","journal-title":"Am J Men's Health"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.4103\/sjg.SJG_617_18"},{"issue":"3","key":"e_1_3_2_16_2","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.avdiab.2012.04.001","article-title":"Obesity in children and adolescents in Gulf countries: Facts and solutions","volume":"28","author":"Abdul-Rasoul MM","year":"2012","unstructured":"Abdul-Rasoul MM. Obesity in children and adolescents in Gulf countries: Facts and solutions. Avances en Diabetologia. 2012;28(3):64\u20139.","journal-title":"Avances en Diabetologia"},{"key":"e_1_3_2_17_2","first-page":"441","article-title":"Obesity: An emerging problem in Saudi Arabia. Analysis of data from the National Nutrition Survey","volume":"13","author":"Al-Othaimeen A","year":"2006","unstructured":"Al-Othaimeen A, Al-Nozha M, Osman AK. Obesity: An emerging problem in Saudi Arabia. Analysis of data from the National Nutrition Survey. East Mediterr Health J. 2006 Nov 30;13:441\u20138.","journal-title":"East Mediterr Health J"},{"key":"e_1_3_2_18_2","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.2147\/RMHP.S346206","article-title":"Gender Differences in the Attitudes and Management of People with Obesity in Saudi Arabia: Data from the ACTION-IO Study","volume":"15","author":"Almubark RA","year":"2022","unstructured":"Almubark RA, Alqahtani S, Isnani AC, Alqarni A, Shams M, Yahia M, Alfadda AA. Gender Differences in the Attitudes and Management of People with Obesity in Saudi Arabia: Data from the ACTION-IO Study. Risk Manag Healthc Policy. 2022 Jun 3;15:1179\u20131188","journal-title":"Risk Manag Healthc Policy"},{"issue":"3","key":"e_1_3_2_19_2","doi-asserted-by":"crossref","first-page":"311","DOI":"10.3390\/healthcare9030311","article-title":"Obesity in Saudi Arabia in 2020: Prevalence, Distribution, and Its Current Association with Various Health Conditions","volume":"9","author":"Althumiri NA","year":"2021","unstructured":"Althumiri NA, Basyouni MH, AlMousa N, AlJuwaysim MF, Almubark RA, BinDhim NF, Alkhamaali Z, Alqahtani SA. Obesity in Saudi Arabia in 2020: Prevalence, Distribution, and Its Current Association with Various Health Conditions. Healthcare (Basel). 2021 Mar 11;9(3):311.","journal-title":"Healthcare (Basel)"},{"issue":"3","key":"e_1_3_2_20_2","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1381\/096089204322917936","article-title":"Patient motivation for bariatric surgery: Characteristics and impact on outcomes","volume":"14","author":"Libeton M","year":"2004","unstructured":"Libeton M, Dixon JB, Laurie C, O'Brien PE. Patient motivation for bariatric surgery: Characteristics and impact on outcomes. Obes Surg. 2004;14(3):392\u20138.","journal-title":"Obes Surg"},{"issue":"7","key":"e_1_3_2_21_2","doi-asserted-by":"crossref","first-page":"1741","DOI":"10.1007\/s11695-016-2525-1","article-title":"Histopathological Changes in Laparoscopic Sleeve Gastrectomy Specimens: Prevalence, Risk Factors, and Value of Routine Histopathologic Examination","volume":"27","author":"Safaan T","year":"2017","unstructured":"Safaan T, Bashah M, El Ansari W, Karam M. Histopathological Changes in Laparoscopic Sleeve Gastrectomy Specimens: Prevalence, Risk Factors, and Value of Routine Histopathologic Examination. Obes Surg. 2017;27(7):1741\u20139.","journal-title":"Obes Surg"},{"issue":"1","key":"e_1_3_2_22_2","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1007\/s11695-015-1726-3","article-title":"Should We Abandon Routine Microscopic Examination in Bariatric Sleeve Gastrectomy Specimens?","volume":"26","author":"AbdullGaffar B","year":"2016","unstructured":"AbdullGaffar B, Raman L, Khamas A, AlBadri F. Should We Abandon Routine Microscopic Examination in Bariatric Sleeve Gastrectomy Specimens? Obes Surg. 2016;26(1):105\u201310.","journal-title":"Obes Surg"},{"issue":"3","key":"e_1_3_2_23_2","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1007\/s11695-012-0821-y","article-title":"Gastric histopathologies in patients undergoing laparoscopic sleeve gastrectomies","volume":"23","author":"Almazeedi S","year":"2013","unstructured":"Almazeedi S, Al-Sabah S, Al-Mulla A, Al-Murad A, Al-Mossawi A, Al-Enezi K, et al. Gastric histopathologies in patients undergoing laparoscopic sleeve gastrectomies. Obes Surg. 2013;23(3):314\u20139.","journal-title":"Obes Surg"},{"issue":"1","key":"e_1_3_2_24_2","doi-asserted-by":"crossref","first-page":"18","DOI":"10.4103\/2347-2618.158693","article-title":"Histopathology results of Jordanian patients after laparoscopic sleeve gastrectomy","volume":"3","author":"Obeidat F","year":"2015","unstructured":"Obeidat F, Shahait A, Shanti H, Al-Momani H, Abu Halaweh S. Histopathology results of Jordanian patients after laparoscopic sleeve gastrectomy. Saudi J Obes. 2015;3(1):18.","journal-title":"Saudi J Obes"},{"issue":"3","key":"e_1_3_2_25_2","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.3748\/wjg.v22.i3.1311","article-title":"Helicobacter pylori associated gastric intestinal metaplasia: Treatment and surveillance","volume":"22","author":"Liu KS","year":"2016","unstructured":"Liu KS, Wong IO, Leung WK. Helicobacter pylori associated gastric intestinal metaplasia: Treatment and surveillance. World J Gastroenterol. 2016 Jan 21;22(3):1311\u201320.","journal-title":"World J Gastroenterol"},{"issue":"4","key":"e_1_3_2_26_2","doi-asserted-by":"crossref","first-page":"1383","DOI":"10.1007\/s13304-021-01181-6","article-title":"Management of gastric intestinal metaplasia in patients undergoing routine endoscopy before bariatric surgery","volume":"74","author":"Cheng YL","year":"2022","unstructured":"Cheng YL, Elli EF. Management of gastric intestinal metaplasia in patients undergoing routine endoscopy before bariatric surgery. Updates Surg. 2022 Aug;74(4):1383\u20131388.","journal-title":"Updates Surg"},{"issue":"5","key":"e_1_3_2_27_2","first-page":"549","article-title":"Association of Hypercholesterolemia With Gastric Intestinal Metaplasia, Findings After Sleeve Gastrectomy Pathology Review","volume":"32","author":"Kermansaravi M","year":"2022","unstructured":"Kermansaravi M, Rezvani M, Elmi Sadr F, Valizadeh R, Kabir A, Pazouki A. Association of Hypercholesterolemia With Gastric Intestinal Metaplasia, Findings After Sleeve Gastrectomy Pathology Review. Surg Laparosc Endosc Percutan Tech. 2022 Oct 1;32(5):549\u2013553.","journal-title":"Surg Laparosc Endosc Percutan Tech"},{"issue":"4","key":"e_1_3_2_28_2","first-page":"402","article-title":"The usefulness of Giemsa staining to diagnose Helicobacter pylori in patients with preneoplastic lesions","volume":"37","author":"Garc\u00eda-Carmona S","year":"2022","unstructured":"Garc\u00eda-Carmona S, Arango-Viana JC, Ahumada-Rodr\u00edguez E, Agudelo-Mesa J, P\u00e9rez-Cala T, Mart\u00ednez A, et al. The usefulness of Giemsa staining to diagnose Helicobacter pylori in patients with preneoplastic lesions. Revista colombiana de Gastroenterolog\u00eda. 2022 Dec;37(4):402\u20139.","journal-title":"Revista colombiana de Gastroenterolog\u00eda"},{"issue":"1","key":"e_1_3_2_29_2","doi-asserted-by":"crossref","first-page":"2013","DOI":"10.4293\/JSLS.2013.00259","article-title":"Histopathologic findings in the resected specimen of a sleeve gastrectomy","volume":"19","author":"Clapp B","year":"2015","unstructured":"Clapp B. Histopathologic findings in the resected specimen of a sleeve gastrectomy. J Soc Laparoendosc Surg. 2015;19(1):2013\u20135.","journal-title":"J Soc Laparoendosc Surg"},{"issue":"6","key":"e_1_3_2_30_2","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1016\/j.soard.2020.02.002","article-title":"Routine preoperative endoscopy in patients undergoing bariatric surgery","volume":"16","author":"Chang VC","year":"2020","unstructured":"Chang VC, Pan P, Shah SK, Srinivasan A, Haberl E, Wan C, et al. Routine preoperative endoscopy in patients undergoing bariatric surgery. Surg Obes Relat Dis. 2020;16(6):745\u201350.","journal-title":"Surg Obes Relat Dis"},{"key":"e_1_3_2_31_2","first-page":"121","article-title":"Epidemiology, survival, and costs of localized gastrointestinal stromal tumors","volume":"4","author":"Rubin JL","year":"2011","unstructured":"Rubin JL, Sanon M, Taylor DC, Coombs J, Bollu V, Sirulnik L. Epidemiology, survival, and costs of localized gastrointestinal stromal tumors. Int J Gen Med. 2011 Feb 14;4:121\u201330.","journal-title":"Int J Gen Med"}],"container-title":["Annals of Saudi Medicine"],"original-title":[],"language":"en","deposited":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T07:41:42Z","timestamp":1754379702000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.annsaudimed.net\/doi\/10.5144\/0256-4947.2025.218"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":30,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.5144\/0256-4947.2025.218"],"URL":"https:\/\/doi.org\/10.5144\/0256-4947.2025.218","relation":{},"ISSN":["0256-4947","0975-4466"],"issn-type":[{"type":"print","value":"0256-4947"},{"type":"electronic","value":"0975-4466"}],"subject":[],"published":{"date-parts":[[2025,7]]}}}