Gastritis, duodenogastric reflux and bacteriology of the gastric remnant in patients operated for peptic ulcer by Billroth I operation
Pääkkönen, M.; Aukee, S.; Syrjänen, K.; Mäntyjärvi, R.
Annals of Clinical Research 17(1): 32-36
1985
ISSN/ISBN: 0003-4762 PMID: 4015029 Document Number: 249126
Of 101 patients underoing Billroth I gastrectomy (BI) 14 yr previously, it was possible to investigate 39. General abdominal symptoms, hematological status, basal (BAO) and maximal (MAO) hydrochloric acid secretion were studied before, and 1 yr and 14 yr after the operation. Stump mucosa morphology was investigated before the operation and 14 yr afterward. Duodenogastric reflux with radioisotope and fasting bile reflux methods and stump bacteriology were studied at the last follow-up and compared with those of controls who had had peptic ulcer 15 yr ago. Only 10% of the operated patients could be classified as Visick grade III, the others being grades I-II. At the time of the follow-up, mean body weight had not changed. Serum Fe was better at 14 than at 1 yr after the operation. BAO and MAO decreased significantly after the operation, but these decreases did not continue during the postoperative period. Duodenogastric reflux was significantly greater in the gastrectomized patients than in the controls. Neither the progression of gastritis nor the degree of postoperative gastritis correlated with the reflux. Of the operated patients, 6% had normal stump mucosa and 80% had atrophy. From the stump, colonic bacteria were cultured in 44% of the patients, pharyngeal flora in 71% and Candida in 56%. The stomach bacteriology of the controls was: 10% colonic, 35% pharyngeal and 30% Candida. The general status of BI patients remains good. Although gastritis progresses to atrophy and duodenogastric reflux increases, the reflux and atrophy do not seem to be related. In spite of increasing atrophy hydrochloric acid secretion continues.