Spontaneous clearance of Helicobacter pylori after pylorus-preserving gastrectomy for gastric cancer

Miyashita,Tomoharu; Miwa,Koichi; Inokuchi,Masafumi; Nakagawara,Hisatoshi; Tajima,Hidehiro; Takamura,Hiroyuki; Ninomiya,Itasu; Kitagawa,Hirohisa; Fushida,Sachio; Fujimura,Takashi; Hattori,Takanori; Ohta,Tetsuo

doi:10.3892/or.2013.2472

Spontaneous clearance of Helicobacter pylori after pylorus-preserving gastrectomy for gastric cancer

Authors:
- Tomoharu Miyashita
- Koichi Miwa
- Masafumi Inokuchi
- Hisatoshi Nakagawara
- Hidehiro Tajima
- Hiroyuki Takamura
- Itasu Ninomiya
- Hirohisa Kitagawa
- Sachio Fushida
- Takashi Fujimura
- Takanori Hattori
- Tetsuo Ohta
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Affiliations: Department of Gastroenterologic Surgery, Kanazawa University Hospital, Kanazawa, Ishikawa 920-8641, Japan, Houju Memorial Hospital, Nomi, Ishikawa 923-1226, Japan, Department of Pathology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
Published online on: May 15, 2013 https://doi.org/10.3892/or.2013.2472
Pages: 299-303

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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 99mTc-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.

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