the laparoscopic sleeve gastrectomy ( lsg ) has become a favored procedure in the worldwide fight against the obesity pandemic . the restrictive and metabolic effects of the lsg are made possible by the vertical resection of a large portion of the stomach , including the fundus . there seem to be some common methods of performing the operation , and as we move forward as a community of bariatric / metabolic surgeons , the procedure will likely become more standardized , similar to the roux - en - y gastric bypass ( rnygb ) . meanwhile , it is incumbent on the bariatric / metabolic surgeon to collect data on the lsg so that we can learn as much as possible about it and the long- and short - term effects of the operation . there is a dearth of published data on histopathologic changes in the resected specimens of lsg patients . unlike the rnygb the size of the resected stomach also obviously differs from the size of a preoperative biopsy specimen in bariatric patients . this is an observational study that is intended to answer the following questions : what are the common histopathologic findings in resected stomach specimens in morbidly obese patients undergoing an lsg ? can information be gained that may be helpful in determining future guidelines for preoperative workup ? this is an observational , retrospective study of resected stomach specimens of consecutive patients undergoing an lsg from august 2008 to december 2012 . the specimens were removed without a specimen extraction bag , directly through the abdominal wall , by enlarging a 15-mm port site . representative section blocks of 2 mm in thickness were fixed in formalin and paraffin and stained with hematoxylin - eosin and were examined by pathologists in the form of permanent slides sliced to 2 m in thickness . all patients had given specific informed consent before surgery for study of any resected specimens and proper disposal of said specimens . the data were deidentified , and an excel spreadsheet ( microsoft , redmond , washington ) was created for data management and analysis . our patient population is from the texas - mexico border area and was mostly hispanic , of mexican descent . one hundred forty - five patients over a 3-year period had specimens available for review . the mean starting body mass index was 47.5 kg / m ( range , 3572.8 kg / m ) . a minority of patients , 62 ( 49.7% ) , had histopathologic findings in the resected specimen . the main histopathologic findings were acute and chronic gastritis in 4 patients , chronic gastritis in 61 , and follicular lymphoid hyperplasia in 11 . the rate of h. pylori was low , but special staining for microorganisms was not routinely performed early in this series . a poster was presented at a meeting of the international federation for the surgery of obesity and metabolic disorders european chapter in 2012 ( borg et al ) , and a report by a group from kuwait was recently published ( almazeedi et al ) . borg et al found a rate of abnormal pathologic findings of 45% , with a 19% rate of h. pylori infection . our finding of a 44% rate of chronic gastritis is closer to the finding of the english group ( borg et al ) , as is our h. pylori infection rate of 18% . this leads to other questions , such as why is there a geographical distribution of gastritis , and what is the importance of these findings in any case ? there is also no consensus on the need for preoperative endoscopy or for preoperative endoscopy with a tissue biopsy . many surgeons support a policy of checking for h. pylori preoperatively , but this is not standardized and can be performed in multiple ways . a serum antigen test , a urease breath test , or a stool antigen test may be used . a tissue biopsy with giemsa staining moreover , the argument can be made that a preoperative determination of the presence of h. pylori may not be necessary because access to the entire remaining stomach remains , in contradistinction to the rnygb . the information obtained from these specimens has no immediate clinical ramifications as far as changing the postoperative course of lsg patients . however , only by reporting our results can we build enough data to look for patterns of disease and possibly come up with new preoperative algorithms . what is the role of proton pump inhibitors preoperatively ? is preoperative body mass index correlated with any of these histologic findings ? by building a body of literature regarding our findings , we can lay the groundwork for analysis and interpretation . this study will help build a dataset regarding the resected stomachs of morbidly obese individuals .
background and objectives : the vertical sleeve gastrectomy is quickly becoming a preferred bariatric operation . 
 there is a dearth of published data about histopathologic changes in the specimens of morbidly obese patients , especially sleeve patients . 
 the aim of this study is to add more data about the characteristics of the resected gastric specimens to the published literature.methods:a prospective database of all patients undergoing laparoscopic sleeve gastrectomies at a single institution was used to gather our data . 
 patient characteristics such as age , sex , and initial body mass index were examined . 
 the pathology reports of these patients were examined for any histopathologic changes or findings.results:one hundred forty - five patients over a 3-year period had specimens available for review . 
 ninety - seven of the patients were women . 
 the mean starting body mass index was 47.5 kg / m2 ( range , 3572.8 kg / m2 ) . 
 the mean age at the time of the operation was 43.1 years . 
 a minority of patients , 62 ( 49.7% ) , had histopathologic findings in the resected specimens . 
 the main histopathologic findings were acute and chronic gastritis in 4 patients , chronic gastritis in 61 , and follicular lymphoid hyperplasia in 11 . 
 one leiomyoma and 2 fundic polyps were found . 
 seventy - three patients had no histopathologic changes.conclusion:a minority of patients had pathologic findings in the resected specimens . 
 this study will help build a dataset regarding the resected stomachs of morbidly obese individuals . 
 these results can help determine what histopathologic findings can be expected after sleeve gastrectomies .