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Comparative Study
, 12 (9), 1508-11

Behavior of the Infection by Helicobacter Pylori of the Gastric Remnant After Subtotal Gastrectomy and Roux-en-Y Anastomosis for Benign Diseases

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Comparative Study

Behavior of the Infection by Helicobacter Pylori of the Gastric Remnant After Subtotal Gastrectomy and Roux-en-Y Anastomosis for Benign Diseases

Attila Csendes et al. J Gastrointest Surg.

Abstract

Introduction: Reinfection by Helicobacter pylori of the gastric remnant after partial gastrectomy has been implicated in the development of gastric cancer at the gastric stump.

Objective: The aim of this study is to determine the rate of infection by H. pylori after partial gastrectomy and Roux-en-Y anastomosis for benign disease.

Materials and methods: A total of 79 patients with long segment Barrett's esophagus were submitted to vagotomy, anti-reflux surgery, two thirds distal gastrectomy, and Roux-en-Y anastomosis 70 cm long. In all preoperative biopsy samples were taken from the antrum. After surgery, four endoscopic studies were performed in different periods of time. Mean follow-up was 98 months after operation (60-240).

Results: Three groups of patients were identified: (a) group 1, 43 patients (54%) who had no preoperative infection by H. pylori and remained so late after surgery; (b) group 2, 21 patients (27%) who had no preoperative infection by H. pylori but presented infection of the gastric remnant that increased parallel to the length of follow-up; (c) group 3, 15 patients (19%) who presented infection by H. pylori before surgery. From them, 11 showed reinfection of the gastric remnant, while four patients had no reinfection.

Conclusion: After partial gastrectomy and Roux-en-Y anastomosis for benign disease, there are three different patterns of behavior regarding reinfection or not by H. pylori. A total of 41% of patients presented H. pylori reinfection at the gastric remnant after Roux-en-Y anastomosis, which increased parallel to the length of follow-up.

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