Mucosal changes in the gastric stump 20-25 years after partial gastrectomy.
Out of 421 patients who had partial gastrectomy 20-25 years ago for gastric or duodenal ulcer, 108 were examined by endoscopy with multiple biopsy. In no case were the endoscopic appearances of the mucosae interpreted as malignant, though in 2 patients the clinical history suggest malignant disease. Histological examination revealed infiltrating carcinoma in 4 patients, 3 of whom had intramucosal carcinoma only. 3 further patients had severe dysplasia (carcinoma-in-situ). Only 1 patient had a near-normal mucosa close to the anastomosis; in the remainder the gastric remnant showed various degress of dysplasia, metaplasia, or chronic atrophic gastritis. In the patients with carcinoma only 28 (12%) of the 226 biopsy specimens revealed the malignant lesion. Patients who have had partial gastrectomy for benign lesions are at high risk of gastric-stump carcinoma. If, 20 years after operation, they have an endoscopy with multiple biopsy, stump carcinoma may be detected early when the prognosis after operation is probably good.
D000328:Adult; D000368:Aged; D001706:Biopsy; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods; D005753:Gastric Mucosa / Q000473:pathology*; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway; D010437:Peptic Ulcer / Q000601:surgery; D011178:Postgastrectomy Syndromes / Q000175:diagnosis / Q000453:epidemiology; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D013997:Time Factors