The Significance of Helicobacter pylori Infection in Patients with Gastric Resection

Rodica Redis1, Ana Bratu2, Dan Redis1, Laurentiu Cozlea1, Simona Mocan2
1) Public Health Center. 2) University of Medicine and Pharmacy, Târgu Mures

Abstract

The aim of the present study was to investigate the incidence of Helicobacter pylori infection in patients with gastric resection (Pean-Billroth I and Billroth II) and to correlate its presence with clinical, endoscopical and histopathological changes.
Material and methods. All patients examined in the Endoscopy Unit of the 2nd Medical Clinic Tg.Mures between April 01, 1997 and March 31, 1999 were included in the series. Every patient had had a gastric resection for gastroduodenal ulcer and they were symptomatic at the moment of examination. Clinical examination and a gastroscopy with multiple biopsies for histopathological examination and for Helicobacter pylori determination were undertaken.

Results
. The series consisted of 70 patients (4 women and 66 men) with mean age 55.2 years. Helicobacter pylori was detected in 16 (22.85%) patients, and was associated in all cases with gastritis of remnant stomach. Gastric cancer was evidenced in 5 (7.14%) patients with remnant stomach and peptic ulcer in 4 (5.71%) patients.

Conclusions
. The incidence of Helicobacter pylori infection in patients with gastric resection was significantly lower compared to patients with an anatomic normal stomach. Pean- Billroth I is the most frequent type of anastomosis and that is accountable because it maintains the duodenum in the digestive circuit. No differences of Helicobacter pylori incidence were observed between the two types of surgical reconstruction. The role of Helicobacter pylori in ulcer relapsing in the gastrectomized patients remains to be demonstrated.

Key words

Gastric remnant _ gastric carcinoma _ peptic ulcer _ Helicobacter pylori