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. 1983 Nov 12;287(6403):1407–1410. doi: 10.1136/bmj.287.6403.1407

Changes in gastric mucosa after vagotomy and gastrojejunostomy for duodenal ulcer.

P C Watt, J M Sloan, T L Kennedy
PMCID: PMC1549670  PMID: 6416435

Abstract

Gastric mucosa was studied histologically in 141 patients. Eighty two had undergone vagotomy and gastrojejunostomy between 15 and 25 years previously for duodenal ulcer, and 59 control patients had a long history (minimum 15 years) of duodenal ulcer treated medically. No carcinoma was found in either group. Two patients with severe dysplasia and 13 patients with moderate dysplasia were found in the study group, compared with none in the control group (p less than 0.01). Intestinal metaplasia was seen in 44 (53%) of the study group and 16 (27%) of the control group (p less than 0.01). Atrophy and gastritis were more severe (p less than 0.01 for atrophy; p = 0.05 for gastritis) in the study group. Gastric mucosal changes were more severe after surgical treatment for duodenal ulcer than after medical treatment, and possibly a high incidence of gastric carcinoma may occur 25 years after vagotomy and gastrojejunostomy.

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Selected References

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

  1. Cheli R., Simon L., Aste H., Figus I. A., Nicoló G., Bajtai A., Puntoni R. Atrophic gastritis and intestinal metaplasia in asymptomatic Hungarian and Italian populations. Endoscopy. 1980 May;12(3):105–108. doi: 10.1055/s-2007-1021722. [DOI] [PubMed] [Google Scholar]
  2. Correa P., Cuello C., Duque E. Carcinoma and intestinal metaplasia of the stomach in Colombian migrants. J Natl Cancer Inst. 1970 Feb;44(2):297–306. [PubMed] [Google Scholar]
  3. 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]
  4. 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]
  5. 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]
  6. Farrands P. A., Blake J. R., Ansell I. D., Cotton R. E., Hardcastle J. D. Endoscopic review of patients who have had gastric surgery. Br Med J (Clin Res Ed) 1983 Mar 5;286(6367):755–758. doi: 10.1136/bmj.286.6367.755. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. JOHNSTON D. H. BLIND GASTRIC AND DUODENAL MUCOSAL BIOPSIES IN PATIENTS WITH DUODENAL ULCER AND THOSE WITH AN ULCER-LIKE SYNDROME. South Med J. 1964 Jan;57:79–84. doi: 10.1097/00007611-196401000-00017. [DOI] [PubMed] [Google Scholar]
  8. MORSON B. C. Carcinoma arising from areas of intestinal metaplasia in the gastric mucosa. Br J Cancer. 1955 Sep;9(3):377–385. doi: 10.1038/bjc.1955.36. [DOI] [PMC free article] [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. Morgenstern L., Yamakawa T., Seltzer D. Carcinoma of the gastric stump. Am J Surg. 1973 Jan;125(1):29–38. doi: 10.1016/0002-9610(73)90005-6. [DOI] [PubMed] [Google Scholar]
  11. Morson B. C., Sobin L. H., Grundmann E., Johansen A., Nagayo T., Serck-Hanssen A. Precancerous conditions and epithelial dysplasia in the stomach. J Clin Pathol. 1980 Aug;33(8):711–721. doi: 10.1136/jcp.33.8.711. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Peitsch W., Becker H. D. Frequency and prognosis of gastric stump cancer. Front Gastrointest Res. 1979;5:170–177. doi: 10.1159/000402326. [DOI] [PubMed] [Google Scholar]
  13. Peitsch W., Becker H. D. Was ist gesichert in der Pathogenese udn Häufigkeit des primären Carcinoms im operierten Magen? Chirurg. 1979 Jan;50(1):33–38. [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. Schrumpf E., Serck-Hanssen A., Stadaas J., Aune S., Myren J., Osnes M. Mucosal changes in the gastric stump 20-25 years after partial gastrectomy. Lancet. 1977 Sep 3;2(8036):467–469. doi: 10.1016/s0140-6736(77)91599-9. [DOI] [PubMed] [Google Scholar]
  17. Serck-Hanssen A. Precancerous lesions of the stomach. Scand J Gastroenterol Suppl. 1979;54:104–105. [PubMed] [Google Scholar]
  18. Stalsberg H., Taksdal S. Stomach cancer following gastric surgery for benign conditions. Lancet. 1971 Nov 27;2(7735):1175–1177. doi: 10.1016/s0140-6736(71)90489-2. [DOI] [PubMed] [Google Scholar]
  19. Welvaart K., Warnsinck H. M. The incidence of carcinoma of the gastric remnant. J Surg Oncol. 1982 Oct;21(2):104–106. doi: 10.1002/jso.2930210208. [DOI] [PubMed] [Google Scholar]

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