title: Changes in the histology and function of gastric mucosa and in Helicobacter pylori colonization during a long-term follow-up period after vagotomy in duodenal ulcer patients.
abstract: OBJECTIVE
  To investigate changes in the histology and the Helicobacter pylori (H. pylori) prevalence and density of the gastric mucosa, as well as in fasting serum gastrin and serum pepsinogen I, depending on completeness of vagotomy, and in cases of recurrent ulcer, during 14 years after operation in duodenal ulcer patients.
  
  
  METHODS
  122 vagotomized duodenal ulcer patients were studied twice on average 9 and 14 years after operation. The presence of recurrent ulcer and completeness of vagotomy were assessed simultaneously endoscopically and by endoscopic Congo red test. The histology of the gastric antrum and corpus mucosa was assessed in accordance with the Sydney system. The amount of H. pylori in the specimens was detected by microscopic counting; gastrin and pepsinogen I in serum were determined radioimmunologically.
  
  
  RESULTS
  During the 14-year follow-up period, complete vagotomy patients were characterized by a smaller amount of active antrum gastritis and a larger amount of active chronic corpus gastritis involving corpus atrophy in 46% of cases 14 years after operation. Recurrent ulcer patients were characterized by a significantly higher prevalence of high-grade H. pylori colonization and active mucosal inflammation in the antrum as well as by a lower level of active mucosal inflammation and atrophy in the corpus and a higher serum pepsinogen I level compared with complete vagotomy cases. The data of incomplete vagotomy patients without recurrent ulcer became more similar to those recorded for recurrent ulcer patients.
  
  
  CONCLUSIONS
  In duodenal ulcer patients, changes in the histology of the gastric antrum and corpus mucosa as well as in H. pylori prevalence and density and in serum pepsinogen I levels are different depending on completeness of vagotomy during 14 years after operation.
authors.affiliation: Clinic of Surgery, Tartu University Clinics, Tartu, Estonia. margot.peetsalu@kliinikum.ee
authors.forename: Margot
authors.initials: M
authors.lastname: Peetsalu
authors.forename: Julio
authors.initials: J
authors.lastname: Valle
authors.forename: Matti
authors.initials: M
authors.lastname: Härkönen
authors.forename: Heidi-Ingrid
authors.initials: HI
authors.lastname: Maaroos
authors.forename: Ants
authors.initials: A
authors.lastname: Peetsalu
mesh_terms: D000328:Adult; D000368:Aged; D015169:Colony Count, Microbial; D004381:Duodenal Ulcer / Q000382:microbiology / Q000473:pathology* / Q000601:surgery; D004384:Duodenoscopy; D005260:Female; D005500:Follow-Up Studies; D005745:Gastric Acidity Determination; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology*; D005755:Gastrins / Q000097:blood*; D005756:Gastritis / Q000382:microbiology / Q000473:pathology*; D016481:Helicobacter Infections / Q000382:microbiology / Q000473:pathology*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D020116:Pepsinogen A / Q000097:blood*; D011706:Pyloric Antrum / Q000382:microbiology / Q000473:pathology; D012008:Recurrence; D014629:Vagotomy, Proximal Gastric; D015167:Vagotomy, Truncal
chemical_list: D005755:Gastrins; D020116:Pepsinogen A