Atak Ibrahim, Ozdil Kamil, Yücel Metin, Caliskan Mujgan, Kilic Ali, Erdem Hasan, Alimoglu Orhan
General Surgery Clinic, Umraniye Training and Research Hospital, Istanbul, Turkey.
Hepatogastroenterology. 2012 Jan-Feb;59(113):59-61. doi: 10.5754/hge11244.
BACKGROUND/AIMS: Laparoscopic cholecystectomy is the gold standard treatment for symptomatic gallstones. The goal of this study was to investigate the effect of cholecystectomy on alkaline reflux, histopathological changes in the gastric mucosa and H. pylori colonization.
Eighty five patients who had undergone laparoscopic cholecystectomy were included in this trial (20 males; 65 females; 44.97 ± 11.22 years). All the patients had an upper gastrointestinal endoscopy before and 6 months after the surgery and biopsies in the antrum and corpus were taken to investigate the mucosal changes and assay for the presence of H. pylori.
At 6 months post-surgery, the presence of bile in the fasting gastric fluid and an increase in the endoscopic gastritis findings were detected. While none of the patients had chemical gastritis prior to surgery, 7 patients were diagnosed with this condition after surgery. Intestinal metaplasia was detected in 6 patients prior to surgery and 20 patients after surgery. H. pylori was observed in 64 patients before surgery and 52 patients after surgery.
An increase in duodenogastric reflux, alkaline reflux gastritis and intestinal metaplasia, and a reduction in H. pylori colonization were observed to occur post-cholecystectomy.
背景/目的：腹腔镜胆囊切除术是有症状胆结石的金标准治疗方法。本研究的目的是调查胆囊切除术对碱性反流、胃黏膜组织病理学变化和幽门螺杆菌定植的影响。
本试验纳入了85例行腹腔镜胆囊切除术的患者（男性20例；女性65例；年龄44.97±11.22岁）。所有患者在手术前和手术后6个月均接受了上消化道内镜检查，并在胃窦和胃体取活检以调查黏膜变化并检测幽门螺杆菌的存在情况。
术后6个月，检测到空腹胃液中有胆汁存在，且内镜下胃炎表现增加。术前无患者患有化学性胃炎，术后有7例患者被诊断为此病。术前6例患者检测到肠化生，术后20例患者检测到肠化生。术前64例患者检测到幽门螺杆菌，术后52例患者检测到幽门螺杆菌。
胆囊切除术后观察到十二指肠胃反流、碱性反流性胃炎和肠化生增加，幽门螺杆菌定植减少。
