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Surgical suppression of gastric acid secretion. Lessons from long-term follow-up studies
1Dept. of Surgery, School of Postgraduate Medicine and Biological Sciences, University of Keele, Stoke on Trent, Staffs., England.
Abstract:
This paper reviews data from case controls studies, cohort studies, and long-term follow-up papers of over 30,000 patients following surgical reduction of gastric acid secretion 20-40 years postoperatively. There is an increase in gastric cancer which becomes highly significant 20 years after Billroth II resection and rises thereafter, many studies showing a three- or four-fold increase compared with a non-operative control or contrast population. There is little doubt that surgical depression of gastric acid secretion is associated with the development of carcinoma of the stomach. The mechanisms by which this development may occur are discussed.