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  • Title: Helicobacter pylori and recurrent ulceration after highly selective vagotomy.
    Author: Martin IG, Diament RH, Dixon MF, Axon AT, Johnston D.
    Journal: Eur J Gastroenterol Hepatol; 1995 Mar; 7(3):207-9. PubMed ID: 7743300.
    Abstract:
    OBJECTIVE: To examine the relationship between Helicobacter pylori and recurrent ulceration after highly selective vagotomy (HSV). SETTING: Academic Department of Surgery at a teaching hospital. PATIENTS: Thirty-eight patients (26 men and 12 women) were studied 2-21 years after HSV. Seven patients had recurrent ulceration. Each patient underwent tests of acid secretion before and 1 week after HSV together with later endoscopic examination of the stomach and duodenum. Four biopsies were taken from the duodenum and gastric antrum. RESULTS: There was no statistical difference in acid output between patients with and those without recurrent ulceration (peak acid output 46.9 versus 55.8 mmol/h, respectively; not significant) before operation. After operation, insulin stimulated acid secretion was significantly higher in patients who later developed recurrent ulceration (0.26 versus 4.1 mmol/h, respectively; P < 0.02). The endoscopic biopsies were tested for H. pylori infection (90 versus 86% for patients without and those with recurrent ulceration, respectively; not significant), gastric metaplasia within the duodenum (23 versus 14% for patients without and those with recurrent ulceration, respectively; not significant), antral gastritis (86 versus 71% for patients without and those with recurrent ulceration, respectively; not significant) and antral intestinal metaplasia (52 versus 43% for those without and those with recurrent ulceration, respectively; not significant). CONCLUSION: H. pylori infection is not influenced by HSV and ulcer recurrence is determined by the completeness of vagotomy rather than by H. pylori status.
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