Analysis of clinical characteristics and related factors of Helicobacter pylori infection in gastric stump lesion

Abstract

Objective To explore the clinical characteristics and related factors of Helicobacter pylori (Hp) infection in gastric stump lesion.Methods Eighty-nine patients with subtotal gastrectomy gastrointestinal symptoms underwent gastroscope,the clinical data were retrospectively analyzed.The relationship between gastric Hp infection and different operation reasons,different operation,different degree of inflammation,postoperative time,the existence of bile reflux was assessed.Results There were 29 cases of gastric Hp infection,the positive rate of Hp was 32.6％ (29/89).There were no significant difference between different preoperative disease such as duodenal ulcer (bleeding/perforation),gastric ulcer (bleeding/perforation),gastric cancer,leiomyosarcoma and HP infection (P ＞0.05).There was no significant different positive rate of Hp infection between Billroth Ⅰ and Billroth Ⅱ after operation (P ＞0.05).The rate of Hp infection increased with the degree of inflammation (moderate to severe) in gastric stump and anastomotic inflammation.There were significant difference [gastritis severity of inflammation:27.3％ (12/44) vs.57.1％ (16/28),anastomotic inflammation:25 ％ (10/40) vs.50％ (18/36),P ＜ 0.05] ;there was significant difference between two groups of more than 10 years [43.9％ (18/41)] and less than 10 years [22.9％ (11/48)] of Hp infection rate (x2 =4.433,P =0.035) ; the positive rate of Hp infection in group of no bile reflux under gastroscopy were higher than the group of bile reflux,there was significant difference [22.2％ (10/45) vs.43.2％ (19/44),x2 =4.449,P =0.035).Multivariate Logistic regression analysis showed that,the degree of inflammation (severe) and bile reflux was associated with gastric Hp infection,inflammation (severe) was the dominant risk factor [OR =1.24,95％ CI:1.22-1.56,P =0.01],with bile reflux were protective factors [OR =0.76,95％CI:0.58-0.99,P =0.04].Conclusions Hp infection can promote and aggravate the gastric remnant mucosa inflammation,Hp infection and bile reflux can lead to gastric mucosa pathological changes,there can be independence pathogenic factors,also can cause at the same time,regulate the eradication of residual gastric Hp infection is very important,also deal with the residual stomach regular line of gastroscope and Hp,histologic examination. Key words: Helicobacter pylori; Gastrectomy; Residual stomach; Bile reflux