ULCER RECURRENCE AFTER GASTRIC-SURGERY - IS HELICOBACTER-PYLORI THE CULPRIT

Objectives: Helicobacter pylori is the most important cause of recurre nt peptic ulcer disease. However, its role in ulcer recurrence after p eptic ulcer surgery is unclear. We aimed at studying the prevalence an d distribution of H. pylori in patients who had undergone peptic ulcer surgery, and any association between H. pylori infection and ulcer re currence in these patients. Methods: Patients with previous vagotomy o r partial gastrectomy presenting with dyspepsia or ulcer bleeding were recruited. Ulcer recurrence was documented by endoscopy. Biopsy speci mens mere taken from the gastric remnant and gastroenteric anastomosis in patients with previous partial gastrectomy, or from the antrum and corpus in vagotomized patients. H. pylori infection was detected by e ither a positive rapid urease test or the presence of the bacteria on histology. Results: Ninety-three patients were studied; 73 patients (7 8%) had partial gastrectomy and 20 (22%) had vagotomy with drainage. H . pylori infection was documented in 36 patients (49%) in the gastrect omy group and in 13 (65%) in the vagotomy group. Thirty-six patients i n the gastrectomy group had recurrent ulcers and 15 (42%) of them had H. pylori infection. Twelve patients in the vagotomy group had recurre nt ulcers and eight (67%) of them were H. pylori positive. The prevale nce of H. pylori infection did not differ bet cr een patients with or without ulcer recurrence. Conclusion: H.pylori infection cannot accoun t for ulcer recurrence after peptic ulcer surgery.