Peptic diseases and Helicobacter pylori infection after pancreatogastrostomy

To investigate the correlation between peptic diseases and Helicobacter pylori after pancreatogastrostomy. Pylorus-preserving pancreatodudenectomy is associated with an increased risk of postoperative peptic diseases. They are thought to be associated with Helicobacter pylori. Little is known about the long-term effects of instillation of alkaline pancreatic juice on the gastric mucosa and Helicobacter pylori infection.

We periodically checked the histology and Helicobacter pylori infection of gastric mucosae in 16 patients who had undergone pancreatogastrostomy and pylorus-preserving pancreatodudenectomy. Helicobacter pylori infection and gastritis were assessed according to the culture grade and the updated Sydney System.

A stomal ulcer occurred in one patient without Helicobacter pylori. Another 2 patients with Helicobacter pylori infection contracted gastric ulcers. They were cured with anti-ulcer drugs in a short period of time. Gastroesophageal reflux disease occurred in one patient without Helicobacter pylori. None of the patients' Helicobacter pylori infectious states changed postoperatively. Culture grade of Helicobacter pylori significantly decreased after pancreatogastrostomy. The severity of gastritis tended to ameliorate after pancreatogastrostomy.

Pancreatogastrostomy appears to decrease the grade of Helicobacter pylori infection. Peptic diseases are rather frequent minor grade complications. However, they are unlikely to be associated with Helicobacter pylori.