Management of Helicobacter pylori infection after gastric surgery.
The Maastricht IV/Florence Consensus Report and the Second Asia-Pacific Consensus Guidelines strongly recommend eradication of Helicobacter pylori (H. pylori) in patients with previous gastric neoplasia who have undergone gastric surgery. However, the guidelines do not mention optimal timing, eradication regimens, diagnostic tools, and follow-up strategies for patients undergoing gastrectomy and do not indicate if eradication of H. pylori reduces the risk of marginal ulcer or stump cancer in the residual stomach after gastrectomy. The purpose of this review is to provide an update which may help physicians to properly manage H. pylori infection in patients who have undergone gastric surgery. This review focuses on (1) the microenvironment change in the stomach after gastrectomy; (2) the phenomenon of spontaneous clearance of H. pylori after gastrectomy; (3) the effects of H. pylori on gastric atrophy and intestinal metaplasia after gastrectomy; (4) incidence and clinical features of ulcers developing after gastrectomy; (5) does eradication of H. pylori reduce the risk of gastric stump cancer in the residual stomach? (6) does eradication of H. pylori reduce the risk of secondary metachronous gastric cancer in the residual stomach? and (7) optimal timing and regimens for H. pylori eradication, diagnostic tools and follow-up strategies for patients undergoing gastrectomy.
Yang-Sheng Lin, Ming-Jen Chen, Shou-Chuan Shih, Ming-Joug Bair, Horng-Yuan Wang, Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei 104, Taiwan.
Yang-Sheng
YS
Lin
Yang-Sheng Lin, Ming-Jen Chen, Shou-Chuan Shih, Ming-Joug Bair, Horng-Yuan Wang, Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei 104, Taiwan.
Ming-Jen
MJ
Chen
Yang-Sheng Lin, Ming-Jen Chen, Shou-Chuan Shih, Ming-Joug Bair, Horng-Yuan Wang, Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei 104, Taiwan.
Shou-Chuan
SC
Shih
Yang-Sheng Lin, Ming-Jen Chen, Shou-Chuan Shih, Ming-Joug Bair, Horng-Yuan Wang, Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei 104, Taiwan.
Ming-Joug
MJ
Bair
Yang-Sheng Lin, Ming-Jen Chen, Shou-Chuan Shih, Ming-Joug Bair, Horng-Yuan Wang, Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei 104, Taiwan.
Ching-Ju
CJ
Fang
Yang-Sheng Lin, Ming-Jen Chen, Shou-Chuan Shih, Ming-Joug Bair, Horng-Yuan Wang, Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei 104, Taiwan.
Horng-Yuan
HY
Wang
D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005743:Gastrectomy / Q000009:adverse effects; D018530:Gastric Stump / Q000473:pathology; D016481:Helicobacter Infections / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects* / Q000254:growth & development / Q000472:pathogenicity; D006801:Humans; D016609:Neoplasms, Second Primary; D011182:Postoperative Care; D011183:Postoperative Complications / Q000175:diagnosis / Q000382:microbiology / Q000517:prevention & control*; D054328:Proton Pump Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D012307:Risk Factors; D012698:Serologic Tests; D013270:Stomach / Q000382:microbiology* / Q000601:surgery*; D013274:Stomach Neoplasms / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors
Atrophic gastritis; Gastrectomy; Gastric stump; Helicobacter pylori; Metaplasia; Stomach neoplasms; Stomach ulcer; Treatment outcome