Literature DB >> 18612708

Behavior of the infection by Helicobacter pylori of the gastric remnant after subtotal gastrectomy and Roux-en-Y anastomosis for benign diseases.

Attila Csendes1, Gladys Smok, Ana María Burgos.   

Abstract

INTRODUCTION: Reinfection by Helicobacter pylori of the gastric remnant after partial gastrectomy has been implicated in the development of gastric cancer at the gastric stump.
OBJECTIVE: The aim of this study is to determine the rate of infection by H. pylori after partial gastrectomy and Roux-en-Y anastomosis for benign disease.
MATERIALS AND METHODS: A total of 79 patients with long segment Barrett's esophagus were submitted to vagotomy, anti-reflux surgery, two thirds distal gastrectomy, and Roux-en-Y anastomosis 70 cm long. In all preoperative biopsy samples were taken from the antrum. After surgery, four endoscopic studies were performed in different periods of time. Mean follow-up was 98 months after operation (60-240).
RESULTS: Three groups of patients were identified: (a) group 1, 43 patients (54%) who had no preoperative infection by H. pylori and remained so late after surgery; (b) group 2, 21 patients (27%) who had no preoperative infection by H. pylori but presented infection of the gastric remnant that increased parallel to the length of follow-up; (c) group 3, 15 patients (19%) who presented infection by H. pylori before surgery. From them, 11 showed reinfection of the gastric remnant, while four patients had no reinfection.
CONCLUSION: After partial gastrectomy and Roux-en-Y anastomosis for benign disease, there are three different patterns of behavior regarding reinfection or not by H. pylori. A total of 41% of patients presented H. pylori reinfection at the gastric remnant after Roux-en-Y anastomosis, which increased parallel to the length of follow-up.

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Year:  2008        PMID: 18612708     DOI: 10.1007/s11605-008-0571-2

Source DB:  PubMed          Journal:  J Gastrointest Surg        ISSN: 1091-255X            Impact factor:   3.452


  18 in total

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