A comparative study of gastric histopathology after partial gastrectomy between the gastroenterostomy area and gastric body.

One hundred and thirty partially gastrectomized subjects, who had been operated on for benign peptic ulcers, were studied to assess the histologic changes in the remaining gastric mucosa and its implications for gastric carcinogenesis. Endoscopic examination and multiple mucosal biopsies from the gastroenterostomy area and gastric body were compared histopathologically. Gastric carcinoma was found in two instances among these 130 patients, making a prevalence rate of 1.5% for carcinoma in the residual stomach. Chronic atrophic gastritis and pseudopyloric metaplasia were found to have developed more often in the gastroenterostomy mucosa than in the gastric body mucosa (p less than 0.001). The mean value of the gastritis score for gastroenterostomy mucosa (2.7 +/- 1.3) was statistically higher than that for the gastric body (2.1 +/- 1.0; p less than 0.001). The degree and types of histologic alteration in the gastric mucosa were also affected by the type of operation and by the postoperative duration. The mean value of the gastritis score and the frequency of pseudopyloric metaplasia, whether in the gastroenterostomy area and/or at the gastric body, were higher in Billroth II resections than in Billroth I resections. The gastritis score and the frequency of pseudopyloric metaplasia increased as the postoperative period increased. However, in the same postoperative period, the mean values of the gastritis score and the frequency of pseudopyloric metaplasia were higher in the gastroenterostomy mucosa than in the gastric body. Gastric dysplasia was more common in the gastroenterostomy area than in the gastric body. Patients who had received a Billroth II resection and those with a longer postoperative period had a higher frequency of gastric dysplasia.