Yeast bezoar formation following gastric surgery

Area of Science:

• Gastroenterology
• Surgical Complications
• Mycology

Background:

• Yeast bezoars are recognized late complications following gastric surgery.
• The incidence and development of bezoars are significantly influenced by the type of surgical procedure performed.
• Vagotomy, especially when combined with Billroth I resection, creates highly favorable conditions for yeast bezoar formation.

Purpose of the Study:

• To investigate the incidence and characteristics of yeast bezoars as a complication of gastric surgery.
• To identify surgical procedures and patient factors associated with yeast bezoar formation.
• To explore potential therapeutic interventions and preventive strategies for yeast bezoars.

Main Methods:

• Retrospective analysis of patient data following various gastric operations.
• Identification of yeast bezoar cases and correlation with surgical procedures.
• Evaluation of clinical presentation, timing of onset, and resolution patterns of bezoars.
• Assessment of therapeutic interventions including gastric lavage, antimycotics, and acid-modifying agents.

Main Results:

• Yeast bezoars frequently occur after gastric operations, with vagotomy being a significant risk factor.
• Vagotomy combined with Billroth I resection showed the highest incidence, with 50% of patients developing bezoars.
• Bezoars typically manifest within one year post-surgery and often resolve spontaneously within the first follow-up year.
• Therapeutic outcomes were inconclusive, and no definitive preventive measures are currently established.

Conclusions:

• Altered gastric acid conditions and impaired postoperative gastric motility are key factors contributing to yeast bezoar formation.
• While many yeast bezoars resolve spontaneously, they can present as symptomatic late complications.
• Further research is needed to establish effective prevention and treatment protocols for yeast bezoars.