Guerre J, Chaussade S, Tulliez M, Gaudric M, Zone A
Service d'Hépato-Gastro-Entérologie, Hôpital Cochin, Paris.
Ann Chir. 1991;45(10):905-8.
In 38 patients who had been operated for peptic ulcer (32) or gastric cancer (6), we performed upper GI endoscopy with biopsies. HP was found in the mucosa in 8 out of 10 patients with highly selective vagotomy, 5 out of 11 patients with gastrectomy for ulcer, 6 out of 11 patients with vagotomy-pyloroplasty and in only 1 case out of 6 with gastrectomy for cancer. These results are in agreement with other publications. Bilio-pancreatic reflux into the stump probably explains why HP was found in only 50% of cases with suppression of pyloric function, compared with 80% after highly selective vagotomy. Interstitial gastritis was present in every case infected with HP, but the same gastritis was present in one half of mucosas, without infection by HP. This particular gastritis in probably caused by reflux. The role of HP in the relapse of ulcers therefore remains to be demonstrated.
在38例因消化性溃疡(32例)或胃癌(6例)接受手术的患者中,我们进行了上消化道内镜检查并取活检。在10例接受高选择性迷走神经切断术的患者中,有8例在黏膜中发现幽门螺杆菌(HP);在11例因溃疡行胃切除术的患者中,有5例发现HP;在11例接受迷走神经切断术 - 幽门成形术的患者中,有6例发现HP;而在6例因癌症行胃切除术的患者中,仅1例发现HP。这些结果与其他出版物一致。胆汁 - 胰液反流至残端可能解释了为什么在幽门功能受抑制的病例中,只有50%发现HP,而高选择性迷走神经切断术后这一比例为80%。在每例感染HP的病例中均存在间质性胃炎,但在未感染HP的黏膜中,有一半也存在同样的胃炎。这种特殊的胃炎可能是由反流引起的。因此,HP在溃疡复发中的作用仍有待证实。