Gastroenterostoma after Billroth antrectomy as a premalignant condition

Robert Sitarz, Ryszard Maciejewski, Wojciech P. Polkowski, G. Johan A Offerhaus

Research output: Contribution to journalArticlepeer-review


Gastric stump carcinoma (GSC) following remote gastric surgery is widely recognized as a separate entity within the group of various types of gastric cancer. Gastrectomy is a well established risk factor for the development of GSC at a long time after the initial surgery. Both exo-as well as endogenous factors appear to be involved in the etiopathogenesis of GSC, such as achlorhydria, hypergastrinemia and biliary reflux, Epstein-Barr virus and Helicobacter pylori infection, atrophic gastritis, and also some polymorphisms in interleukin-1β and maybe cyclo-oxygenase-2. This review summarizes the literature of GSC, with special reference to reliable early diagnostics. In particular, dysplasia can be considered as a dependable morphological marker. Therefore, close endoscopic surveillance with multiple biopsies of the gastroenterostomy is recommended. Screening starting at 15 years after the initial ulcer surgery can detect tumors at a curable stage. This approach can be of special interest in Eastern European countries, where surgery for benign gastroduodenal ulcers has remained a practice for a much longer time than in Western Europe, and therefore GSC is found with higher frequency.

Original languageEnglish (US)
Pages (from-to)3201-3206
Number of pages6
JournalWorld Journal of Gastroenterology
Issue number25
StatePublished - Jul 7 2012
Externally publishedYes


  • Endoscopic surveillance
  • Gastrectomy
  • Gastric stump cancer
  • Risk factors

ASJC Scopus subject areas

  • Gastroenterology


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