Occurrence and significance of Helicobacter pylori infection after gastric surgery.

Occurrence and significance of Helicobacter pylori (Hp) infection in patients having undergone partial and total gastric resection was studied. Forty-nine patients after gastric resection with Billroth I and II operation (28 patients due to ulcer and 21 patients due to gastric cancer), and 8 patients with total gastrectomy due to gastric cancer were selected. In addition, 40 patients with active peptic ulcer disease, 32 patients suffering from gastric cancer, and 28 patients with non-ulcer dyspepsia as a control group were enrolled. Occurrence of Hp in patients having been operated on due to ulcer disease was slightly lower than in controls (50% vs. 54%), but it was significantly lower than in patients with active peptic ulcer (50% vs. 85%, p < 0.001). On the other hand, in patients who were operated on due to gastric cancer, Hp was much less frequent than in the control group, as well as in patients in the preoperative period (9.5% vs. 54% and 72%, p < 0.001). As a conclusion, since in our series colonization with Hp was found to be less frequent after gastric resection than before surgery, its aetiologic significance in postoperative chronic gastritis and ulceration seems to be unlikely. Therefore, the routine postoperative eradication of Hp appears to be unnecessary in such patients.