Endoscopic 13C-urea breath test for detection of Helicobacter pylori infection after partial gastrectomy.
OBJECTIVE
It is difficult to interpret the results of 13C-urea breath test (UBT) in gastrectomy patients because the test urea may pass through the stomach faster. The aim of this study is to evaluate the efficacy of the modified endoscopic UBT for detection of Helicobacter pylori (H. pylori) infection in the residual stomach.


METHODS
An endoscopic UBT was performed in 44 patients who had undergone partial gastrectomy. At endoscopy, 20 mL of water containing 100mg of 13C-urea were sprayed onto the gastric mucosa and an intragastric gas sample was immediately collected through the biopsy channel. Breath samples were collected at 20 min after spraying 13C-urea.


RESULTS
The intragastric delta13CO2 value in H. pylori-positive patients was significantly higher than those of 20-minute breath samples. The maximum sensitivity and specificity of intragastric samples were 97% and 100% with cutoff point of 5 per thousand, respectively. The sensitivity and specificity of breath samples at 20 min were 71.4% and 66.7% with cutoff point of 0.6 per thousand, respectively.


CONCLUSIONS
An endoscopic UBT was superior to a standard UBT to detect H. pylori infection after partial gastrectomy.
Urita
Yoshihisa
Y
Department of General Medicine and Emergency Care, Toho University School of Medicine, Tokyo, Japan. foo@eb.mbn.or.jp
Maeda
Tadashi
T
Ishihara
Susumu
S
Sugimoto
Motonobu
M
Watanabe
Toshiyasu
T
Domon
Kaoru
K
Miki
Kazumasa
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001944:Breath Tests / Q000379:methods*; D002247:Carbon Isotopes / Q000737:chemistry*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000473:pathology*; D016480:Helicobacter pylori / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008953:Models, Anatomic; D011178:Postgastrectomy Syndromes / Q000175:diagnosis* / Q000473:pathology; D011183:Postoperative Complications; D012680:Sensitivity and Specificity; D013997:Time Factors; D014508:Urea / Q000032:analysis* / Q000737:chemistry*
D002247:Carbon Isotopes; D014508:Urea