Helicobacter pylori(H-P) is said to be associated with various gastric diseases such as gastritis, peptic ulcer, non ulcer dyspepsia and even certain gastric carcinoma.
We have investigated prospectively the effect oftotal gastrectomy on serum anti Helicobacter Pylkori Immunoglobulin -G(anti H-P IgG) titer using Cobos core anti-Helicobater Pylori EIA kit(Roche).
Tre anti H-P IgG titers were checked preoperatively and postoperatively at days 30, 60, 90, 120, 180. We excluded to study those patients with normal anti H-P IgG titer preoperatively in 3 cases, and those received anti H-P chemotherapy.
The total number of patients who received total gastrectomy were 24(Group I) between January 1994 to October 1994. We also checked anti H-P IgG sero titer to subtotal gastrectomy patients (Group II+III), 32 cases, to compare with Group I.
After subtotal gastrectomy, they are reconstructed to Roux-en Y limb(see figure 1) without exception and thus we could exclude the effect of bile on the H-P.
The Group II patients had near total gastric resections and group III were subtotally resected.
@ES The results were as follows;
@ES 1) the mean preoperative serum anti H-P IgG titer were 53.20 Uml in group I, 90.15 U/ml in group II and 75.80 u/ml in group III and those titers are not different (P=01506).
2) The postoperative anti H-P IgG titers were decreased stadily in group I(see table 3, 4 and figure 2,5), but the titers were fluctuated after subtotal gastric resection(group II. III) (see table 3, 4, figure 3, 4, 5).
3) We calculated postoperative anti H-P IgG serotiters which becomes half of preoperative leve (half life). It was 2 months in group I, 3 and 5months in group II and III.
4) The percentages of anti-H-P IgG sero-negativity were 91% in group I, 74% in group II and 32% in group III at 6 months after operation.
The conclusion of this study is the preoperatively anti H-P IgG titers become decline postoperatively in those patient with total gastrectomy.
The titers become halved every 2 months and most patients(91%) become seronegative at the and 6 months.
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