Alterations of Gastric Mucosa Following a Graded Partial Gastrectomy for Duodenal Ulcer

Alterations in gastric mucosal morphology were studied in 56 patients before and after a partial gastrectomy graded by the preoperative values of total acid output (MAO) following large doses of histamine. In the group of patients secreting 30 mEq/h or more and who were subjected to a two-thirds gastrectomy, the thickness of the parietal cell layer decreased significantly from a preoperative mean value of 0.71 mm to 0.60 mm at three months and 0.51 mm at twelve months after operation. The thickness of the total mucosa, 1.02 mm, did not show significant alterations. The frequency of gastritis, which was low pre-operatively, increased abruptly, and at twelve months about two-thirds of the cases had moderate or severe atrophic gastritis. In the group of patients secreting less than 30 mEq/h and who received a one-third gastrectomy, significantly lower values were preoperatively found for MAO and the parietal cell layer thickness, while the frequency of gastritis was higher. Twelve months after operation the parietal cell layer was only slightly thinner than preoperatively, and not significantly different from that of the high secreting group. The frequency of atrophic gastritis was similar in both groups.