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Mucosal changes in the gastric remnant: long-term effects of bile reflux diversion and Helicobacter pylori infection.

Åhsberg, Kristina LU ; Hammar, Eric and Staël von Holstein, Christer LU (2003) In European Journal of Gastroenterology and Hepathology 15(1). p.35-40
Abstract
Objective Bile reflux is thought to be responsible for reflux gastritis and stump carcinoma occurring after partial gastrectomy for peptic ulcer. Gastritis and gastric carcinoma are also correlated with Helicobacter pylori. The aim of this study was to investigate whether diversion of enteric reflux and the presence of H. pylori infection alter long-term histological developments in the gastric remnant. Methods Twenty-nine patients partially gastrectomized for peptic ulcer were reoperated on with re-resection and a Roux-en-Y reconstruction because of reflux gastritis (12 patients) or severe dysplasia/early gastric cancer (17 patients). The resected specimens and subsequent biopsies from the new anastomotic region taken at endoscopies 5-17... (More)
Objective Bile reflux is thought to be responsible for reflux gastritis and stump carcinoma occurring after partial gastrectomy for peptic ulcer. Gastritis and gastric carcinoma are also correlated with Helicobacter pylori. The aim of this study was to investigate whether diversion of enteric reflux and the presence of H. pylori infection alter long-term histological developments in the gastric remnant. Methods Twenty-nine patients partially gastrectomized for peptic ulcer were reoperated on with re-resection and a Roux-en-Y reconstruction because of reflux gastritis (12 patients) or severe dysplasia/early gastric cancer (17 patients). The resected specimens and subsequent biopsies from the new anastomotic region taken at endoscopies 5-17 years after reoperation were evaluated regarding the presence of H. pylori, the grade of active and non-active chronic gastritis, and the premalignant changes - atrophy, intestinal metaplasia and dysplasia. Results A progression of active chronic gastritis, atrophy, intestinal metaplasia and dysplasia was seen after re-resection and Roux-en-Y reconstruction. Non-active chronic gastritis remained unchanged. The development was, in general, independent of H. pylori infection. Conclusions Enteric reflux may perhaps induce a histological transformation of the gastric mucosa that cannot be reversed, even if the reflux is diverted. In our study, H. pylori infection had no impact on the histological development. Factors other than enteric reflux and H. pylori infection might also be of importance. (Less)
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author
organization
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type
Contribution to journal
publication status
published
subject
in
European Journal of Gastroenterology and Hepathology
volume
15
issue
1
pages
35 - 40
publisher
Lippincott Williams & Wilkins
external identifiers
  • wos:000180797900007
  • pmid:12544692
  • scopus:0037246616
ISSN
1473-5687
language
English
LU publication?
yes
id
3b545e5d-487e-41a0-b20b-a386854ae409 (old id 111884)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12544692&dopt=Abstract
date added to LUP
2007-07-20 10:59:07
date last changed
2018-01-07 05:44:39
@article{3b545e5d-487e-41a0-b20b-a386854ae409,
  abstract     = {Objective Bile reflux is thought to be responsible for reflux gastritis and stump carcinoma occurring after partial gastrectomy for peptic ulcer. Gastritis and gastric carcinoma are also correlated with Helicobacter pylori. The aim of this study was to investigate whether diversion of enteric reflux and the presence of H. pylori infection alter long-term histological developments in the gastric remnant. Methods Twenty-nine patients partially gastrectomized for peptic ulcer were reoperated on with re-resection and a Roux-en-Y reconstruction because of reflux gastritis (12 patients) or severe dysplasia/early gastric cancer (17 patients). The resected specimens and subsequent biopsies from the new anastomotic region taken at endoscopies 5-17 years after reoperation were evaluated regarding the presence of H. pylori, the grade of active and non-active chronic gastritis, and the premalignant changes - atrophy, intestinal metaplasia and dysplasia. Results A progression of active chronic gastritis, atrophy, intestinal metaplasia and dysplasia was seen after re-resection and Roux-en-Y reconstruction. Non-active chronic gastritis remained unchanged. The development was, in general, independent of H. pylori infection. Conclusions Enteric reflux may perhaps induce a histological transformation of the gastric mucosa that cannot be reversed, even if the reflux is diverted. In our study, H. pylori infection had no impact on the histological development. Factors other than enteric reflux and H. pylori infection might also be of importance.},
  author       = {Åhsberg, Kristina and Hammar, Eric and Staël von Holstein, Christer},
  issn         = {1473-5687},
  language     = {eng},
  number       = {1},
  pages        = {35--40},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {European Journal of Gastroenterology and Hepathology},
  title        = {Mucosal changes in the gastric remnant: long-term effects of bile reflux diversion and Helicobacter pylori infection.},
  volume       = {15},
  year         = {2003},
}