Iranian Journal of Pathology

Histopathologic Findings in Sleeve Gastrectomy Specimens: Is Routine Pathological Examination Always Necessary?

Document Type : Original Research

Authors

Safa Nourani 1
Elham Mirzaian 1
Mahdis Khazaeli Najafabadi 1
Seyed Mohammad Tavangar 1
Salma Sefidbakht 1
Abdolreza Pazouki 2

1 Department of Pathology, Dr Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

2 Laparoscopic Surgery Department of General Surgery, School of Medicine Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran

https://doi.org/10.30699/ijp.2025.2032599.3316
Abstract
Background & Objective: There are limited findings regarding histopathological changes in sleeve gastrectomy samples and their relationship with preoperative clinical and histopathological characteristics. The present study aims to assess histopathological findings in sleeve gastrectomy samples and identify the main determinants of these changes.
Methods: This cross-sectional study retrospectively reviewed demographic, preoperative clinical, histological, and endoscopic findings of 258 patients who underwent laparoscopic sleeve gastrectomy surgery. Postoperative pathological findings were also evaluated.
Results: Microscopic examination revealed pathological findings in 212 samples (82.2%). The most common histopathological finding reported in patients was chronic gastritis, present in approximately 67.1% of cases, followed by active gastritis in 13.6%. Additionally, 19.0% of patients tested positive for helicobacter pylori infection. A significant association was found between the history of hyperlipidemia and helicobacter pylori positivity (p = 0.039). Before surgery, 80 patients (41.7%) had normal endoscopic results, while at least one significant abnormal finding was observed in 58.3% of cases. However, there was no significant relationship between preoperative endoscopic findings and histopathological changes after surgery in almost all examined patients.
Conclusion: Histopathological examination of sleeve gastrectomy samples reveals a high prevalence of abnormal findings, including active gastritis, Helicobacter pylori infection, intestinal metaplasia, and dysplasia requiring therapeutic management. However, tracking these changes in biopsy samples obtained from endoscopy before surgery may not be sufficient to predict the histopathological findings after sleeve gastrectomy.

Keywords

Sleeve gastrectomy
Histopathological findings
clinical characteristics

Subjects

Copyright © 2026. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The license also allows users to adapt, remix, transform, and build upon the material for any purpose, including commercial use.

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Iranian Journal of Pathology
Volume 21, Issue 1
Winter 2026
Pages 47-52

  • Receive Date 18 June 2024
  • Revise Date 04 September 2024
  • Accept Date 16 September 2025

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