Diagnosis of Helicobacter pylori infection after gastric surgery for peptic ulcer:: Is the rapid urease test useful?

Background: The usefulness of the rapid urease test (RUT) in diagnosing Helicobacter pylori infection after peptic ulcer surgery is unknown. Methods: Patients who had undergone peptic ulcer surgery were offered endoscopic examination if they presented with dyspepsia or gastrointestinal bleeding. Biopsy specimens were taken for RUT and histology from the corpus and the stoma in patients who had undergone partial gastrectomy or from the corpus and the antrum in patients who had undergone vagotomy. Histologic examination using haematoxylin and eosin stain and Warthin-Starry stain were used as the gold standard. Results: Ninety patients were studied (69 had partial gastrectomy and 21 had vagotomy). Forty-three patients (32 in the partial gastrectomy group and 11 in the vagotomy group) were positive for H. pylori by histology. The respective sensitivity of RUT was 59% (stoma) and 75% (corpus) in the partial gastrectomy group (P=0.36) and 55% (antrum) and 73% (corpus) in the vagotomy group (P=0.51). Conclusions: RUT is not sensitive for detecting H. pylori after acid reduction surgery.