The Distribution of Helicobacter pylori and Its Role in Postoperative Remnant Gastritis

Choi, Yeun Jong; Kim, Hyun Soo; Park, Dong Hoon; Kim, Moon Young; Baik, Soon Koo; Lee, Dong Ki; Kwon, Sang Ok; Park, Kwang Hwa

Abstract

BACKGROUND/AIMS: The distribution of Helicobacter pylori (H. pylori) and its effect on postoperative remnant gastritis has not been clearly investigated. Thus, we carried out this study to examine H. pylori positive rate in the body and cardia and to assess the role of H. pylori on the pathogenesis of remnant gastritis. METHODS: Eighty-two patients who had undergone gastric surgery (Billroth I, II) were studied. Four biopsy specimens were obtained from the cardia and oral side of anastomosis for histological analysis and CLO test. The histological grades of gastritis were determined by four parameters of visual analogue scales adopted by updated Sydney system. RESULTS: The overall positive rate of H. pylori was 48.8%. Among the infected patients, H. pylori positive rate was significantly higher in the cardia than in the body (87.5% vs. 37.5%, p<0.01). The H. pylori positivity was not associated with age, sex, primary disease, type of surgery, chemotherapy, and postopertive interval. The gastritis scores of inflammatory cell infiltration were higher in H. pylori positive patients. However, the scores of atrophy and intestinal metaplasia were not significantly different between the two groups. CONCLUSIONS: The H. pylori positive rate is higher in the cardia than in the body of postoperative remnant stomach. It suggests that H. pylori may play an important role in remnant gastritis through acute and chronic inflammatory cell infiltration.