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World J Gastroenterol. Mar 21, 2014; 20(11): 2765-2770
Published online Mar 21, 2014. doi: 10.3748/wjg.v20.i11.2765
Helicobacter pylori infection following partial gastrectomy for gastric cancer
Sanghoon Park, Hoon Jai Chun
Sanghoon Park, Department of Internal Medicine, KEPCO Medical Center, Seoul 132-703, South Korea
Hoon Jai Chun, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Korea University Medical Center, Seoul 136-705, South Korea
Author contributions: Park S and Chun HJ performed the literature search, and collected and analyzed the data; Park S wrote the manuscript; Chun HJ supervised the project.
Correspondence to: Hoon Jai Chun, MD, PhD, Professor, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Korea University Medical Center, Inchon-ro 73, Seongbuk-gu, Seoul 136-705, South Korea. drchunhj@chol.com
Telephone: +82-2-9205699 Fax: +82-2-9531943
Received: August 16, 2013
Revised: October 21, 2013
Accepted: November 1, 2013
Published online: March 21, 2014
Processing time: 214 Days and 3.6 Hours
Abstract

Gastric remnants are an inevitable consequence of partial gastrectomy following resection for gastric cancer. The presence of gastric stumps is itself a risk factor for redevelopment of gastric cancer. Helicobacter pylori (H. pylori) infection is also a well-known characteristic of gastric carcinogenesis. H. pylori colonization in the remnant stomach therefore draws special interest from clinicians in terms of stomach cancer development and pathogenesis; however, the H. pylori-infected gastric remnant is quite different from the intact organ in several aspects and researchers have expressed conflicting opinions with respect to its role in pathogenesis. For instance, H. pylori infection of the gastric stump produced controversial results in several recent studies. The prevalence of H. pylori infection in the gastric stump has varied among recent reports. Gastritis developing in the remnant stomach presents with a unique pattern of inflammation that is different from the pattern seen in ordinary gastritis of the intact organ. Bile refluxate also has a significant influence on the colonization of the stomach stump, with several studies reporting mixed results as well. In contrast, the elimination of H. pylori from the gastric stump has shown a dramatic impact on eradication rate. H. pylori elimination is recognized to be important for cancer prevention and considerable agreement of opinion is seen among researchers. To overcome the current discrepancies in the literature regarding the role of H. pylori in the gastric stump, further research is required.

Keywords: Helicobacter pylori; Gastrectomy; Gastric cancer

Core tip:Helicobacter pylori (H. pylori) are colonizing the remnant stomach after partial gastrectomy for gastric cancer interacts with the remaining gastric stump in a unique way. Many theories have been proposed as to the exact role or etiological manifestation of H. pylori on the remnant stomach relating to prevalence rate, carcinogenesis, and extent of clearance. Yet, studies have provided inconsistent results and no unified opinion has been reached on each topic. This article summarizes findings from the collective investigational reports on the influence of H. pylori in the gastric remnant.