The Eradication Rate of Helicobacter pylori on the Remnant Stomach after Curative Resection for Gastric Cancer and the Influence of Eradication

Korean J Gastrointest Endosc > Volume 35(4); 2007 > Article

Korean Journal of Gastrointestinal Endoscopy 2007;35(4): 216-220.

위암 환자의 위절제술 후 헬리코박터 제균율 및 제균이 잔여위에 미치는 영향

김인경ㆍ백우현ㆍ이재경ㆍ정고은ㆍ김연주ㆍ이창현ㆍ홍경섭ㆍ이상협*ㆍ박영수*ㆍ황진혁*ㆍ김진욱*ㆍ정숙향*ㆍ김나영*ㆍ이동호*ㆍ정현채ㆍ송인성ㆍ김형호^†ㆍ이혜승^‡

서울대학교 의과대학 내과학교실, 분당서울대학교병원 *내과, ^†외과, ^‡병리학과

The Eradication Rate of Helicobacter pylori on the Remnant Stomach after Curative Resection for Gastric Cancer and the Influence of Eradication

In Kyoung Kim, M.D., Woo Hyun Paik, M.D., Jae Kyung Lee, M.D., Goh Eun Chung, M.D., Youn Joo Kim, M.D., Chang Hyun Lee, M.D., Kyoung Sup Hong, M.D., Sang Hyub Lee, M.D.*, Young-Soo Park, M.D.*, Jin-Hyeok Hwang, M.D.*, Jin-Wook Kim, M.D.*, Sook Hyang Jung,

Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Departments of *Internal Medicine, ^†Surgery and ^‡Pathology, Seoul National University Bundang Hospital, Seongnam, Korea

Abstract

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. (Korean J Gastrointest Endosc 2007;35:216-220)

Key Words: H. pylori, Eradication, Gastrectomy, Gastric cancer

주요어: H. pylori, 제균 치료, 위암, 위아전절제술