Helicobacter pylori infection in the remnant stomach after gastrectomy for gastric cancer or peptic ulcer: Preliminary results
Abstract
Helicobacter pylori infection contributes to many gastric diseases like peptic ulcers and gastric cancer. However, few reports mentioned in H. pylori infection after gastrectomy. In this study, we examined H. pylori infection in the remnant stomach by the PCR method with gastric juices and H. pylori IgG antibody (ELISA).
From October 1991 to August 1996, endoscopic examinations were carried out in the First Department of Surgery (Nippon Medical School) and sera were collected from 207 gastric cancer or peptic ulcer patients. H. pylori DNA in the gastric juices was amplified by PCR and detected by agarose gel electrophoresis and Southern blot hybridization. H. pylori DNA in the gastric juices was examined in 66 patients (mean 62 years, M/F = 50/16) after gastrectomy for gastric cancer (50 patients) or peptic ulcer (16 patients). Serum IgG antibody against H. pylori (ELISA) was examined in 111 patients (mean 61.6 years, M/F = 76/35) after gastrectomy for gastric cancer (93 patients) or peptic ulcers (18 patients). H. pylori infection was found in 48/66 (72.7%), and 89/111 (80.2%) patients by PCR and ELISA, respectively.
No significant differences in H. pylori positivity with either PCR or ELISA were found according to age group, sex, time after operation, or disease (gastric cancer or peptic ulcers). Only the type of anastomosis showed statistical significance by the gastric juice-PCR method (P = 0.014). Billroth II anastomosis decreased the rate of H. pylori infection in 7/15 (46.7%), and Billroth I anastomosis in 37/45 (82.2%).
It is concluded that there are no factors affected the positivity of H. pylori in gastric remnant except the type of anastomosis, where a lower incidence of infection was found in Billroth ll anastomosis than in Billroth I. This might reflect the role of bile reflux, which is more common in Billroth ll than in Billroth I, since bile reflux disturbs H. pylori colonization in gastric mucosa.
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