Skip to main content
PMC home page
Gut logoLink to Gut
. 1984 Mar;25(3):238–245. doi: 10.1136/gut.25.3.238

Intragastric N-nitrosation is unlikely to be responsible for gastric carcinoma developing after operations for duodenal ulcer.

M R Keighley, D Youngs, V Poxon, D Morris, T J Muscroft, D W Burdon, J Barnard, P M Bavin, R W Brimblecombe, D W Darkin, et al.
PMCID: PMC1432290  PMID: 6698439

Abstract

Three groups of patients studied after operations which had cured their duodenal ulcer were compared with a control group (no operation, n = 8). The surgical procedures included: proximal gastric vagotomy (n = 7), truncal vagotomy and pyloroplasty (n = 7), truncal vagotomy and antrectomy (n = 8). Samples of gastric juice were aspirated half hourly or hourly over 24 hours for measurement of pH, counts of all identified bacteria, nitrite and total N-nitrosocompounds. Although the pH over 24 hours was significantly higher after proximal gastric vagotomy (p less than 0.05) and truncal vagotomy and antrectomy (p less than 0.001) than controls, there was no difference between truncal vagotomy and pyloroplasty and controls. Counts of nitrate reducing bacteria over 24 hours were also significantly higher after truncal vagotomy and antrectomy than controls (p less than 0.1) but no differences were observed between the other groups. Only after truncal vagotomy and antrectomy was nitrite over 24 hours significantly increased compared with controls (p less than 0.01). Despite these higher values after truncal vagotomy and antrectomy, there was no significant difference in total N-nitrosocompounds between any of the four groups. Whereas bacterial counts and nitrite increased with pH, no correlation was found between total N-nitrosocompounds and pH. These results provide no evidence that exposure to total N-nitrosocompounds is increased after operations for duodenal ulcer.

Full text

PDF
239

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Domellöf L., Eriksson S., Janunger K. G. Carcinoma and possible precancerous changes of the gastric stump after billroth II resection. Gastroenterology. 1977 Sep;73(3):462–468. [PubMed] [Google Scholar]
  2. Domellöf L., Eriksson S., Janunger K. G. Late precancerous changes and carcinoma of the gastric stump after Billroth I resection. Am J Surg. 1976 Jul;132(1):26–31. doi: 10.1016/0002-9610(76)90284-1. [DOI] [PubMed] [Google Scholar]
  3. Domellöf L., Reddy B. S., Weisburger J. H. Microflora and deconjugation of bile acids in alkaline reflux after partial gastrectomy. Am J Surg. 1980 Aug;140(2):291–295. doi: 10.1016/0002-9610(80)90024-0. [DOI] [PubMed] [Google Scholar]
  4. Eberlein T. J., Lorenzo F. V., Webster M. W. Gastric carcinoma following operation for peptic ulcer disease. Ann Surg. 1978 Mar;187(3):251–256. doi: 10.1097/00000658-197803000-00007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Ellis D. J., Kingston R. D., Brookes V. S., Waterhouse J. A. Gastric carcinoma and previous peptic ulceration. Br J Surg. 1979 Feb;66(2):117–119. doi: 10.1002/bjs.1800660211. [DOI] [PubMed] [Google Scholar]
  6. HELSINGEN N., HILLESTAD L. Cancer development in the gastric stump after partial gastrectomy for ulcer. Ann Surg. 1956 Feb;143(2):173–179. doi: 10.1097/00000658-195614320-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Hill M. J. Bacterial metabolism and human carcinogenesis. Br Med Bull. 1980 Jan;36(1):89–94. doi: 10.1093/oxfordjournals.bmb.a071620. [DOI] [PubMed] [Google Scholar]
  8. Keighley M. R., Asquith P., Edwards J. A., Alexander-Williams J. The importance of an innervated and intact antrum and pylorus in preventing postoperative duodenogastric reflux and gastritis. Br J Surg. 1975 Oct;62(10):845–849. doi: 10.1002/bjs.1800621024. [DOI] [PubMed] [Google Scholar]
  9. Milton-Thompson G. J., Lightfoot N. F., Ahmet Z., Hunt R. H., Barnard J., Bavin P. M., Brimblecombe R. W., Darkin D. W., Moore P. J., Viney N. Intragastric acidity, bacteria, nitrite, and N-nitroso compounds before, during, and after cimetidine treatment. Lancet. 1982 May 15;1(8281):1091–1095. doi: 10.1016/s0140-6736(82)92277-2. [DOI] [PubMed] [Google Scholar]
  10. Muscroft T. J., Deane S. A., Youngs D., Burdon D. W., Keighley M. R. The microflora of the postoperative stomach. Br J Surg. 1981 Aug;68(8):560–564. doi: 10.1002/bjs.1800680813. [DOI] [PubMed] [Google Scholar]
  11. Nicholls J. C. Stump cancer following gastric surgery. World J Surg. 1979 Nov;3(6):731–736. doi: 10.1007/BF01654802. [DOI] [PubMed] [Google Scholar]
  12. Pulimood B. M., Knudsen A., Coghill N. F. Gastric mucosa after partial gastrectomy. Gut. 1976 Jun;17(6):463–470. doi: 10.1136/gut.17.6.463. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Reed P. I., Smith P. L., Haines K., House F. R., Walters C. L. Effect of cimetidine on gastric juice N-nitrosamine concentration. Lancet. 1981 Sep 12;2(8246):553–556. doi: 10.1016/s0140-6736(81)90940-5. [DOI] [PubMed] [Google Scholar]
  14. Reed P. I., Smith P. L., Haines K., House F. R., Walters C. L. Gastric juice N-nitrosamines in health and gastroduodenal disease. Lancet. 1981 Sep 12;2(8246):550–552. doi: 10.1016/s0140-6736(81)90939-9. [DOI] [PubMed] [Google Scholar]
  15. Ross A. H., Smith M. A., Anderson J. R., Small W. P. Late mortality after surgery for peptic ulcer. N Engl J Med. 1982 Aug 26;307(9):519–522. doi: 10.1056/NEJM198208263070902. [DOI] [PubMed] [Google Scholar]
  16. Ruddell W. S., Axon A. T., Findlay J. M., Bartholomew B. A., Hill M. J. Effect of cimetidine on the gastric bacterial flora. Lancet. 1980 Mar 29;1(8170):672–674. [PubMed] [Google Scholar]
  17. Ruddell W. S., Bone E. S., Hill M. J., Blendis L. M., Walters C. L. Gastric-juice nitrite. A risk factor for cancer in the hypochlorhydric stomach? Lancet. 1976 Nov 13;2(7994):1037–1039. doi: 10.1016/s0140-6736(76)90962-4. [DOI] [PubMed] [Google Scholar]
  18. Sen N. P., Smith D. C., Schwinghamer L. Formation of N-nitrosamines from secondary amines and nitrite in human and animal gastric juice. Food Cosmet Toxicol. 1969 Jul;7(4):301–307. doi: 10.1016/s0015-6264(69)80366-4. [DOI] [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES