Helicobacter pylori after surgery for duodenal ulcer.
OBJECTIVE
The role of Helicobacter pylori as a cause of peptic ulcer is still subject to controversy. The Kock's postulates have not been yet fulfilled; the bacteria can be found in normal persons, and it persists in the stomach after the ulcer is healed.


METHODS
The authors analyzed 41 persons formerly submitted to surgery (after 8 years and 4 months, as a mean), 31 to highly selective vagotomy, and 10 to truncal or selective vagotomy plus gastroduodenal drainage. All of them were asymptomatic, or had symptoms not related to ulcer relapse.


RESULTS
At endoscopy the ulcers were healed in all 41 individuals, and there was evidence of gastritis in three. The histopathological exam showed gastritis in all biopsy specimens. The search of H. pylori by urease method and by Giemsa staining was positive in 40.


CONCLUSIONS
It was concluded that the gastric acid secretion reduced by vagotomy was the main factor to healing the ulcer, not subordinated to H. pylori.
Künzle
J E
JE
Serviço de Cirurgia de Ribeirao Preto.
Modena
J L
JL
Ziliotto Júnior
A
A
Mendes
J A
JA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001399:Azure Stains; D004322:Drainage; D004381:Duodenal Ulcer / Q000209:etiology / Q000382:microbiology / Q000601:surgery*; D004384:Duodenoscopy; D004941:Esophagitis / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D005744:Gastric Acid / Q000378:metabolism; D005756:Gastritis / Q000175:diagnosis / Q000382:microbiology; D005773:Gastroscopy; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013270:Stomach / Q000382:microbiology*; D014510:Urease; D014629:Vagotomy, Proximal Gastric / Q000009:adverse effects; D015167:Vagotomy, Truncal / Q000009:adverse effects
D001399:Azure Stains; D014510:Urease