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Life sciences · Journal article
World Journal of Gastrointestinal Surgery · September 18, 2026
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BACKGROUNDPersistent Helicobacter pylori (H.pylori) infection is associated with adverse outcomes after gastrectomy for gastric cancer. AIMTo evaluate the association of perioperative H. pylori eradication therapy with long-term survival in patients undergoing distal gastrectomy for gastric cancer. METHODSThis retrospective cohort study involved H. pylori-positive patients who underwent distal gastrectomy with D2 lymphadenectomy for gastric adenocarcinoma at our hospital from January 2016 to January 2021.The patients were divided into a perioperative eradication group and a noneradication group depending on whether they received a 14-day bismuth-containing quadruple regimen.Key measurements included H. pylori status at 6 months, nutritional/inflammatory parameters at 12 months, remnant gastric lesions at 1 year, adjuvant chemotherapy completion, and long-term oncologic outcomes including 5-year overall survival (OS) and disease-free survival (DFS). RESULTSAmong the 271 eligible patients (143 noneradication and 128 eradication), the eradication success rate was 91.41% in the eradication group.Compared with the noneradication group, the eradication group was associated with significantly higher 5year OS (91.41% vs 80.42%, P = 0.010) and 5-year DFS (85.94% vs 72.73%, P = 0.008) and lower rates of metachronous gastric cancer (1.56% vs 7.69%, P = 0.018) and gastric cancer-specific death (6.25% vs 15.38%, P = 0.017).Multivariate Cox regression analysis adjusting for age, sex, pathological tumor-node-metastasis stage, differentiation, and lymphovascular invasion revealed that perioperative eradication remained independently associated with improved OS (hazard ratio = 0.551, P = 0.036) and DFS (hazard ratio = 0.604, P = 0.043). CONCLUSIONIn this retrospective cohort, perioperative H. pylori eradication therapy was independently associated with improved long-term survival and reduced risk of metachronous gastric cancer in patients who underwent distal gastrectomy for gastric cancer.