Epithelial Cell Turnover Is Increased in the Excluded Stomach Mucosa After Roux-en-Y Gastric Bypass for Morbid Obesity

Abstract

Cell proliferation is increased and apoptosis is downregulated in the excluded gastric mucosa compared to the non-operated obese controls. Alterations in cell turnover and in hormonal secretions in these conditions may be of relevance in long-term follow-up.

Postoperative finding of gastric neuroendocrine tumor in a patient undergoing a mini gastric bypass: points to consider

“…It has been reported that gastrin expression in the epithelium of the excluded stomach is modified after Roux-en-Y bypass, as shown after gastroduodenal exclusion, which could influence the proliferation of EC cells. Our observations demonstrate that cell modifications are not strictly related to the surgery, because they can be present before surgery [9].…”

H. PYLORI INFECTION, ENDOSCOPIC, HISTOLOGICAL ASPECTS AND CELL PROLIFERATION IN THE GASTRIC MUCOSA OF PATIENTS SUBMITTED TO ROUX-EN-Y GASTRIC BYPASS WITH CONTENTION RING: a cross sectional endoscopic and immunohistochemical study

“…In our investigation, the proliferative index of epithelial cells through Ki-67 antigen expression increased in the postoperative period (23.8%) when compared to the preoperative (17.1%), mainly in cases with H. pylori presence. Safatle-Ribeiro et al (23) , observed a different result: gastric pouch cell proliferation was of 18.3% (the authors mentioned a treatment for pathogen eradication, but presented no cure confirmation). This result discrepancy could be explained by the higher postoperative H. pylori infection rate we found in our study, mainly in patients with greater period of postoperative follow-up.…”

“…Safatle-Ribeiro et al (23) evaluated 35 patients submitted to RYGB with a postoperative follow-up higher than 36 months and observed Ki-67 antigen expression in the gastric pouch and in the excluded stomach mucosa. They compared these results to the expression of this antigen in the gastric antrum and body of not operated obese patients.…”

Fecal Calprotectin, Elastase, and Alpha-1-Antitrypsin Levels After Roux-en-Y Gastric Bypass; Calprotectin Is Significantly Elevated in the Majority of Patients

“…RYGB causes hyperplasia of the jejunal mucosa of the Roux-limb, but no macroscopic or histologic evidence of inflammation is found in the majority of patients [14, 22]. An increased inflammatory state can be found in the stomach remnant, and more than half of the patients have chronic gastritis in this remnant [23–25]. However, studies in non-RYGB patients with gastritis found no increase in fecal calprotectin [26].…”