Regurgitant bile acids and mucosal injury of the gastric remnant after partial gastrectomy

Influence of bile reflux and Helicobacter pylori infection on gastritis in the remnant gastric mucosa after distal gastrectomy

“…*P < 0.005; **P < 0.01; ***P < 0.05 or gastroduodenal reflux of bile and duodenal contents. [6][7][8]22 We found that the endoscopic severity of remnant gastritis was milder for patients with jejunal interposition (which prevents bile reflux) than for those with either of the Billroth procedures. [9][10][11] In the present study, the endoscopic severity of remnant gastritis was mostly grade 1 or more for both B-I and B-II patients.…”

“…5,6 Reflux of bile and duodenal contents is well known as a major pathogenic factor in reflux gastritis. [6][7][8] Recently, reconstruction procedures such as Roux-en-Y and jejunal interposition (J-I) have been recognized as methods which prevent gastroduodenal regurgitation. [9][10][11] In addition, since the first isolation of Helicobacter pylori from gastric mucosa, by Warren and Marshall in 1983, 12 it has been shown that, pathogenically, this bacterium has close a association with many kinds of gastroduodenal disease, such as atrophic gastritis, 13,14 gastroduodenal ulcer, 15,16 lymphoma of mucosaassociated lymphoid tissue (MALT) type, 17 and others.…”

Endoscopic evaluation of the remnant stomach after gastrectomy: proposal for a new classification

“…It has become important to investigate the remnant stomach after partial gastrectomy for malignancy. Bile reflux and gastritis may be associated with a higher incidence of a second cancer in the remnant stomach [9]. The Dutch Gastric Cancer Trial showed a much higher incidence of anastomotic leakage after B1 than after gastrojejunostomy.…”

Oncological outcomes of function-preserving gastrectomy for early gastric cancer: a multicenter propensity score matched cohort analysis comparing pylorus-preserving gastrectomy versus conventional distal gastrectomy

“…Many reports concerning gastric cancer from the remnant stomach have been published DG distal gastrectomy, M mucosa, MP muscularis propria, PPG pylorus-preserving gastrectomy, SE serosa, SI structures adjacent to serosa, SM submucosa, SS subserosa a The median is given, with the range in parentheses Oncological outcomes of function preserving gastrectomy for early gastric cancer... 715 [28][29][30][31]. The regurgitation of bile or pancreatic juice has been thought to initiate carcinogenesis through mucosal damage in the remnant stomach [32][33][34]. The preservation of the pylorus ring during a DG would assuage gastritis by reducing the reflux of the duodenal contents.…”