Korean J Gastrointest Endosc.
2007 Oct;35(4):216-220.
The Eradication Rate of Helicobacter pylori on the Remnant Stomach after Curative Resection for Gastric Cancer and the Influence of Eradication
- Affiliations
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- 1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
- 2Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. dhljohn@snubh.org
- 3Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
- 4Department of Pathology, Seoul National University Bundang Hospital, Seongnam, Korea.
Abstract
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BACKGROUND/AIMS: There are few reports on the rate of H. pylori eradication and the influence of this eradication in the remnant stomach after a curative resection for a gastric carcinoma.
METHODS
The medical records of patients who had undergone curative gastrectomy for carcinoma between May, 2003 and June, 2006 were reviewed to evaluate the serial H. pylori status. The eradication regimen was a proton pump inhibitor (PPI) based triple therapy (PPI, amoxicillin, clarithromycin). After eradication, the histological changes were reviewed based on the updated Sidney system. In addition, a CLO test and urea breath test were used for the evaluation.
RESULTS
Eighty five patients were found to be positive for a H. pylori infection after the curative gastrectomy. Fifty two patients received eradication therapy and the other 33 patients did not. The eradication rate in patients who received therapy was 82.7% and spontaneous resolution rate in the patients who did not receive therapy was 78.8% (p=0.654). After eradication, the remnant stomach showed a significant decrease in the inflammation and activity scores.
CONCLUSIONS
The eradication rate of H. pylori by PPI based triple therapy in the remnant stomach is similar to that in a non-surgical stomach. The decrease in the inflammation and activity score suggests that the eradication may prevent H. pylori related carcinogenesis. However, the high spontaneous negative conversion rate (78.8%) in the remnant stomach after gastrectomy will require further study.
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