title: Spontaneous clearance of Helicobacter pylori after pylorus-preserving gastrectomy for gastric cancer.
abstract: Residual mucosa in the gastric stump after pylorus-preserving gastrectomy (PPG) is considered a risk factor for the development of gastric stump carcinoma (GSC). Duodenogastric reflux (DGR) and Helicobacter pylori (H. pylori) infection are suspected to contribute to the development of GSC. The aim of this study was to investigate the prevalence of H. pylori in the residual stomach after PPG for gastric cancer and to assess factors associated with the presence of H. pylori. We investigated 72 patients who had undergone PPG at least 1 year prior to the study and were confirmed to be positive for H. pylori infection on presurgical endoscopic biopsy. The extent of DGR, the prevalence of H. pylori infection based on H. pylori stool antigen (HpSA) tests and the severity of gastritis were analyzed in these post-PPG patients. None of the patients had DGR, as shown by (99m)Tc-PMT. Of the 72 post-PPG patients, 33 (46%) were positive for HpSA. The prevalence of H. pylori infection was significantly lower after surgery than before surgery. The endoscopic severity of remnant gastritis, as well as histological inflammation and activity, were higher in H. pylori-positive patients than in H. pylori-negative patients. In conclusion, some patients who undergo PPG and are negative for DGR experience spontaneous clearance of H. pylori infection.
authors.affiliation: Department of Gastroenterologic Surgery, Kanazawa University Hospital, Kanazawa, Ishikawa 920-8641, Japan. tomoharumiya@gmail.com
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Miyashita
authors.forename: Koichi
authors.initials: K
authors.lastname: Miwa
authors.forename: Masafumi
authors.initials: M
authors.lastname: Inokuchi
authors.forename: Hisatoshi
authors.initials: H
authors.lastname: Nakagawara
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Tajima
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takamura
authors.forename: Itasu
authors.initials: I
authors.lastname: Ninomiya
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Kitagawa
authors.forename: Sachio
authors.initials: S
authors.lastname: Fushida
authors.forename: Takashi
authors.initials: T
authors.lastname: Fujimura
authors.forename: Takanori
authors.initials: T
authors.lastname: Hattori
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ohta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005243:Feces / Q000382:microbiology; D005260:Female; D005743:Gastrectomy; D005753:Gastric Mucosa / Q000382:microbiology; D018530:Gastric Stump / Q000601:surgery; D005756:Gastritis / Q000382:microbiology; D016481:Helicobacter Infections; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D013270:Stomach / Q000000981:diagnostic imaging / Q000382:microbiology; D013274:Stomach Neoplasms / Q000382:microbiology* / Q000601:surgery*; D016896:Treatment Outcome