Chronic Gastritis in Cholecystectomized Patients

Abstract

Duodenogastric reflux is considered to be a possible cause of chronic gastritis. This reflux, however, is reported to be common after cholecystectomy. In the present investigation we have studied the possible relation between chronic gastritis and prior cholecystectomy in 106 symptomatic outpatients with prior cholecystectomy and in 131 controls without cholecystectomy. We surveyed their endoscopic biopsy specimens from antral, body, and esophageal mucosa. We found that the mean score and prevalence of chronic antral and body gastritis in cholecystectomized patients was the same as or slightly lower than that in controls. The mean progression of gastritis, when compared with the progression of gastritis in the general population, was slightly slower than expected in the cholecystectomized patients. This slow progression was seen in body gastritis in cholecystectomized patients with a coexisting esophagitis. We conclude that there is no positive correlation between chronic gastritis and prior cholecystectomy. In contrast, this correlation may be negative, especially in patients with esophagitis, in whom an association of the postcholecystectomy state and a possible duodenogastric reflux with normal, nongastritic and nonatrophic body mucosa may facilitate mechanisms favoring the pathogenesis of esophagitis.

Cholecystectomy, peptic ulcer disease and the risk of adenocarcinoma of the oesophagus and gastric cardia

“…Gastrooesophageal re¯ux is a strong risk factor for gastrooesophageal adenocarcinoma 4 , and a previous history of cholecystectomy has been shown to be associated with an increased prevalence of such re¯ux 16,19,24 . Moreover, cholecystectomy increases duodenogastric re¯ux 14,15,18,25 . Components of bile and pancreatic juice cause pHdependent oesophageal damage in animal studies 8,9 , and clinical observations indicate that patients with concomitant gastro-oesophageal and duodenogastric re¯ux have more severe oesophagitis than those with gastrooesophageal re¯ux alone 5±7 .…”

Relation of Gallbladder Function and <i>Helicobacter pylori</i> Infection to Gastric Mucosa Inflammation in Patients with Symptomatic Cholecystolithiasis

“…Still, some studies failed to show any increased DGR after CHE, again utilizing scintigraphy [7, 24] or the Bilitec device [25]. Whether an increased DGR after CHE is also causing histologically evident gastritis is controversially discussed, as is whether an increased DGR (after CHE or per se) is causing symptoms [7, 16,20,21,22, 26, 27]. Increased DGR has also been shown to a lesser degree in patients with gallstones, but without a correlation to symptoms or histologically proven gastritis [7,18,19,20, 22, 23, 28].…”