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. 1978 Mar;187(3):251–256. doi: 10.1097/00000658-197803000-00007

Gastric carcinoma following operation for peptic ulcer disease.

T J Eberlein, F V Lorenzo, M W Webster
PMCID: PMC1396416  PMID: 637580

Abstract

Gastric carcinoma following operation for benign peptic ulcer disease has been considered rare but nine patients have been seen during the past five years. All were male patients, the average time interval from prior ulcer operation to development of cancer was 17 years, but was a short as ten years. The symptoms of cancer are vague and the diagnosis is often delayed. Fiberoptic endoscopy with biopsy of suspicious areas is the most accurate diagnostic approach. Resection of the tumor is indicated if feasible. The poor prognosis of this malignancy is documented. The evidence is reviewed that the creation of achlorhydria with bile reflux increases the risk of development of gastric carcinoma. All patients who undergo peptic ulcer operation require careful long-term follow-up. Vague gastrointestinal symptoms occurring ten years or more after peptic ulcer operation require full evaluation to exclude the presence of gastric cancer.

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Selected References

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  1. BERKOWITZ D., COONEY P., BRALOW S. P. Carcinoma of the stomach appearing after previous gastric surgery for benign ulcer disease. Gastroenterology. 1959 May;36(5):691–697. [PubMed] [Google Scholar]
  2. COFFEY R. J., CARDENAS F. CLINICAL FEATURES OF CARCINOMA OF THE GASTRIC STUMP FOLLOWING GASTRIC RESECTION FOR BENIGN PEPTIC ULCER. Am J Gastroenterol. 1964 Jul;42:77–84. [PubMed] [Google Scholar]
  3. Domellöf L., Eriksson S., Janunger K. G. Late occurrence of precancerous changes and carcinoma of the gastric stump after Billroth II resection. Acta Chir Scand. 1975;141(4):292–297. [PubMed] [Google Scholar]
  4. Domellöf L., Eriksson S., Janunger K. G. Late precancerous changes and carcinoma of the gastric stump after Billroth I resection. Am J Surg. 1976 Jul;132(1):26–31. doi: 10.1016/0002-9610(76)90284-1. [DOI] [PubMed] [Google Scholar]
  5. GIBBS D. D. Carcinoma in the gastric remnant after partial gastrectomy for benign ulceration. A study of three cases illustrating the diagnostic contribution of exfoliative cytology. Gut. 1962 Dec;3:322–326. doi: 10.1136/gut.3.4.322. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Gazzola L. M., Saegesser F. Cancer of the gastric stump following operations for benign gastric or duodenal ulcers. J Surg Oncol. 1975;7(4):293–298. doi: 10.1002/jso.2930070405. [DOI] [PubMed] [Google Scholar]
  7. Graves H. A., Jr, Herrington J. L., Jr Gastric carcinoma developing after surgery for peptic ulcer. Am Surg. 1971 Feb;37(2):73–76. [PubMed] [Google Scholar]
  8. HELSINGEN N., HILLESTAD L. Cancer development in the gastric stump after partial gastrectomy for ulcer. Ann Surg. 1956 Feb;143(2):173–179. doi: 10.1097/00000658-195614320-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Hilbe G., Salzer G. M., Hussl H., Kutschera H. Die Carcinomgefährdung des Resektionsmagens. Langenbecks Arch Chir. 1968;323(2):142–153. doi: 10.1007/BF01441331. [DOI] [PubMed] [Google Scholar]
  10. Imai T., Kubo T., Watanabe H. Chronic gastritis in Japanese with reference to high incidence of gastric carcinoma. J Natl Cancer Inst. 1971 Jul;47(1):179–195. [PubMed] [Google Scholar]
  11. Kobayashi S., Prolla J. C., Kirsner J. B. Late gastric carcinoma developing after surgery for benign conditions. Endoscopic and histologic studies of the anastomosis and diagnostic problems. Am J Dig Dis. 1970 Oct;15(10):905–912. doi: 10.1007/BF02236057. [DOI] [PubMed] [Google Scholar]
  12. Kowalewski K. Relationship between vagotomy, peptic ulcer and gastric adenocarcinoma in rats fed 2,7-diacetylaminogluorene. Can J Surg. 1973 May;16(3):210–217. [PubMed] [Google Scholar]
  13. MORSON B. C. Carcinoma arising from areas of intestinal metaplasia in the gastric mucosa. Br J Cancer. 1955 Sep;9(3):377–385. doi: 10.1038/bjc.1955.36. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Morgenstern L., Yamakawa T., Seltzer D. Carcinoma of the gastric stump. Am J Surg. 1973 Jan;125(1):29–38. doi: 10.1016/0002-9610(73)90005-6. [DOI] [PubMed] [Google Scholar]
  15. Ruddell W. S., Bone E. S., Hill M. J., Blendis L. M., Walters C. L. Gastric-juice nitrite. A risk factor for cancer in the hypochlorhydric stomach? Lancet. 1976 Nov 13;2(7994):1037–1039. doi: 10.1016/s0140-6736(76)90962-4. [DOI] [PubMed] [Google Scholar]
  16. SWYNNERTON B. F., TANNER N. C. Chronic gastric ulcer; a comparison between a gastroscopically controlled series treated medically and a series treated by surgery. Br Med J. 1953 Oct 17;2(4841):841–847. doi: 10.1136/bmj.2.4841.841. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Stalsberg H., Taksdal S. Stomach cancer following gastric surgery for benign conditions. Lancet. 1971 Nov 27;2(7735):1175–1177. doi: 10.1016/s0140-6736(71)90489-2. [DOI] [PubMed] [Google Scholar]
  18. Walker I. R., Strickland R. G., Ungar B., Mackay I. R. Simple atrophic gastritis and gastric carcinoma. Gut. 1971 Nov;12(11):906–911. doi: 10.1136/gut.12.11.906. [DOI] [PMC free article] [PubMed] [Google Scholar]

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