[Helicobacter pylori colonization in surgical patients].

The prevalence of Helicobacter pylori (HP) was examined in 387 patients undergoing endoscopy of the upper gastrointestinal tract. Of central interest was the question to which extent surgical intervention influences the colonisation of the gastric mucosa with HP. The bacillic status was appraised using double microbiological examinations, histological determination and the CLO-test. In 229 patients a 13C-urea-breath test was also carried out (sensitivity 98%). HP could be detected in 90% of all patients presenting with duodenal ulcers as well as in 70% of patients with gastric ulcers, whereas in those patients in whom a lesion of the upper gastrointestinal tract could be excluded through endoscopy. HP was found in only 27%. The prevalence of HP did not increase with age. In patients having undergone distal gastric resection due to gastric ulcers, HP was only rarely found (19%) in the mucosa in the vicinity of the anastomosis following removal of the apparently pathogenetically important antrum mucosa. There was no association between anastomosis ulcers and bacillic colonisation. Following selective proximal vagotomy in patients with duodenal ulcers, HP was found in 80% of all cases. In these patients there was also no association between recurrent ulceration and a HP-positive status. Our results describe the postoperative HP-status after different surgical procedures of ulcer therapy: whereas a distal gastric resection removes the antrum mucosa, which provides the necessary environmental milieu, the HP-colonisation rate after selective proximal vagotomy is similar to that in non-operated ulcer disease.