Decreased risk of gastric stump carcinoma after partial gastrectomy supplemented with bile diversion

The exact incidence of gastric stump cancer is not known. The reported incidence varies greatly, even in studies using similar methods. The aim of this study was to re-evaluate the risk of gastric stump cancer after gastric surgery for peptic ulcer in the Finnish population. A total of 285 patients (252 men and 33 women) operated on for benign peptic ulcer between 1948 and 1954 were followed-up till the end of 1984 (mean follow-up for men = 19.4 years, for women = 22.9 years). At the end of 1984, 58 patients (20%) were still alive without verified gastric cancer. One patient developed gastric cancer within five years after the operation and was excluded from the series. Nine patients (3%) were lost to follow-up. Six patients (four men and two women) of the total 285 developed gastric cancer 6, 7, 8, 21, 25 and 27 years after the operation. The risk of contracting gastric cancer in a control population (no operation) of equal size and age during a similar follow-up period was 6.71 cases for men and 0.86 cases for women (total = 7.57). The observed number (6 patients) does not differ significantly (P less than 0.5) from the expected number (7.57). This study shows that the risk of gastric cancer does not significantly increase after partial gastrectomy for benign peptic ulcer.