Histologic Changes in the Gastroduodenal Mucosa after Long-Term Medical Treatment with Cimetidine or Parietal Cell Vagotomy in Patients with Juxtapyloric Ulcer Disease

Abstract

Biopsy specimens were collected during endoscopy from pre-established sites in the corpus (n = 60), antrum (n = 53), and the duodenal bulb (n = 54) from the same patient before and 2-3 years after parietal cell vagotomy (PVC) or after a similar period of treatment with cimetidine. There was a significant increase in scores of chronic body gastritis after PCV (p < 0.001) even in comparison with the cimetidine group (p < 0.011, for which the scores of chronic body gastritis remained essentially unchanged. The scores of chronic antral gastritis and the incidence of intestinal metaplasia of the antrum increased significantly (p < 0.05) in both the PCV and the cimetidine groups when the two treatment groups were analyzed together. The degree of polymorphonuclear infiltration in the body and antral mucosa, the incidence and severity of duodentitis, and the incidence of gastric metaplasia in the duodenal cap were unaffected by the treatment. In contrast to maintenance treatment with cimetidine PCV seems to accelerate the development of chronic body gastritis. The kappa statistics, as indicator of the reproducibility of histopathologic scoring, were acceptable.

Key Words:

• Cimetidine
• duodenal ulcer
• duodenitis
• gastritis
• parietal cell vagotomy
• prepyloric ulcer