Abstract
Objective: The influence of surgical ulcer treatment on Helicobacter pylori infection as an important pathogenetic factor in gastritis and ulcer disease is still unclear. In this study, we analysed the influence of proximal gastric vagotomy with and without simultaneous perioperative single-shot antibiotic prophylaxis on H. pylori infection, the degree of inflammation and the rate of gastric metaplasia in the duodenum. Design: Twenty-four patients with chronic duodenal ulcer were analysed prospectively for H. pylori infection before proximal gastric vagotomy and at 2 weeks and 3 months following surgery. Thirteen patients received a single-shot therapy of 4 g mezlocillin and 500 mg metronidazole perioperatively. Eleven patients underwent proximal gastric vagotomy without antibiotic treatment. The prevalence of H. pylon infection, the degree of colonization and inflammation and the frequency of gastric metaplasia in the duodenum were analysed. Results: Before the operation, all the patients had a documented H. pylori infection. In patients with perioperative antibiotic treatment H. pylori infection, the degree of inflammation and the frequency of gastric metaplasia were reduced. In patients without antibiotic treatment, only a decrease in gastric metaplasia in the duodenum was observed. Conclusions: Changes in gastric and duodenal physiology caused by proximal gastric vagotomy reduce gastric metaplasia and seem to improve the bactericidal effects of the antibiotics.
| Original language | English |
|---|---|
| Pages (from-to) | 719-725 |
| Number of pages | 7 |
| Journal | European Journal of Gastroenterology and Hepatology |
| Volume | 4 |
| Issue number | 9 |
| State | Published - 1992 |
| Externally published | Yes |