J.Jpn. Surg. Soc.. 96(5): 286-294, 1995

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Original article

EXPERIMENTAL STUDIES ON THE INFLUENCE OF DUODENAL CONTENTS ON THE MUCOSA OF GASTRIC REMNANT

Using the PCNA staining method, we examined the histopathological changes and cytokinetics on the gastric mucosa of the gastric remnant at the anastomosis 10, 20 and 50 weeks after gastrectomy. We conducted the distal gastrectomy in rats and divided them into three groups : Group 1, in which “a sham" operation was performed ; Group 2, in which reflux of duodenum fluids was prevented by Roux-en Y anastomosis ; and Group 3, in which reflux of duodenum fluids was allowed by gastro-jejunal anastomosis.
Adenocarcinoma developed only at the anastomosis of the afferent loops in animals of Group 3 directly exposed to duodenum fluid. The PCNA labeling index at the anastomosis of the afferent loop was high from the early stages. In addition, labeling index tended to increase gradually, and PCNA positive cells were diffusely scattered, which indicated acceleration of cytosis.
From these results, we concluded that the reflux of duodenum fluid was essential for the development of cancer in the remnant stomach. Moteover, cytosis was closely related to the development of epithelial cancer of the gastric mucosa at the anastomosis of the remnant stomach.

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