Cancer in the Excluded Stomach 4 Years after Gastric Bypass

Abstract

Gastric bypass is the preferred operation for treatment of morbid obesity on many services. The evaluation of the excluded stomach is always difficult and a matter of concern for the attending physician. There are only four reported cases of gastric cancer in the distal stomach after gastric bypass. We report a 57-year-old man who had intestinal metaplasia at the time of the Roux-en-Y gastric bypass 4 years ago and now developed an aggressive carcinoma in the bypassed stomach.

Gastric Cancer After Laparoscopic Adjustable Gastric Banding

“…In Europe, gastric banding is the most frequently performed bariatric operation. The risk of esophageal and gastric cancer, especially after restrictive procedures, has only been reported in case reports and in one review [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20].…”

Risk of Upper Gastrointestinal Cancer after Bariatric Operations

“…The patient with the carcinoma in the bypassed stomach at 4 years had had intestinal metaplasia and HP (given eradication therapy) on endoscopy before the RYGBP. 18 Symptoms resulted from distal gastric outlet obstruction in three cases and were associated with tumor infiltration of liver in the fourth patient. 21 A fifth patient presented with anemia that was investigated for 1 year before an endoscopy evaluated the distal stomach through the loop gastrojejunostomy and found two polypoid early gastric cancers.…”

“…4 Five cases of adenocarcinoma of the distal stomach have been reported after gastric bypass. [18][19][20][21][22] Cancer was diagnosed at an advanced stage in four of the cases, 4,5, 8 and 22 years after the procedure. The patient with the carcinoma in the bypassed stomach at 4 years had had intestinal metaplasia and HP (given eradication therapy) on endoscopy before the RYGBP.…”

Schlauchmagenbildung in der Behandlung der morbiden Adipositas

“…Dieser Nachteil muss gegen über dem Vorteil der endoskopischen Diagnostik abgewogen werden. So wurden erwartungsgemäß Fälle eines Magenkarzinoms nach RNY bekannt, die in Folge der fehlenden Möglichkeit zur Endoskopie kaum frühzeitig diagnostizierbar sein dürften [8]. Eine Kontraindikation zur LSG könnte sich aus einer therapieresistenten Refluxkrankheit ergeben [3].…”