Morphological changes in the operated stomach under the influence of duodenogastric reflux. Clinical follow-up over 20 years.

The chronic changes in the gastric mucosa arising years or even decades after surgery and interpreted as a precancerous state are causally related to the unphysiological irritation due to duodenogastric reflux. It was the objective of our study to determine whether there is an increase in alterations in the gastric mucosa of the operated stomach, as a function of postoperative interval and the particular surgical procedure performed, with consideration for the varying degrees of resultant duodenogastric reflux. Specifically, there were 320 patients and three different operative procedures studied with postoperative follow-up averaging a period of up to 20 years. The synopsis of the results shows not only a progression of the premalignancy apparent in the morphology of the mucosa, but also provides an indication of the varying intensity of duodenogastric reflux associated with each of the operative methods.