An experimental study of gastric mucosal proliferation due to regurgitation of duodenal contents.

Abstract

Summary: The changes in morphology and cell proliferation of the gastric mucosa were studied with in vivo experiments on several models of duodenal regurgitation.The following operations were performed on six groups (A-F) of male Wistar rats : (A) sham operation, (B) gastro-je junostomy without gastrectomy, (C) gastrectomy with Billroth II reconstruction, (D) gastrectomy with Billroth I reconstruction, (E) gastrectomy with Billroth II reconstruction and Braun's anastomosis, and (F) gastrectomy and Roux-Y gastrojejunostomy. The morphological changes were evaluated by macro-and microscoropic examination, and cell proliferations were measured by a scintillation counter and by autoradiography.In addition to these investigations, a study was carried out on groups A and B to investigate the effect of duodeno-gastric reflux for a long duration.Morphologically, superficial gastritis and mucus neck cell hyperplasia were recognized in almost all groups. Group B had significantly higher values of cell proliferation.In the long term study, the marked increase in cell proliferation was maintained at almost the same level for a period of 12 months following the operation.These results indicate that the increase in cell proliferation and the presence of atrophic gastritis are the most characteristic features of a gastric mucosa which has been exposed to the duodenal contents.

Surgical management of residual gastric cancer.

“…Most authors report a median patient age of 60-70 years at the time of in the residual stomach. Kobukata (1986) reported that the conditions responsible for the duodeno -gastric ref lux precede an increase in cell proliferation, which in turn may be one of the most important factors for carcinogenesis in the residual stomach following gastrectomy.…”