Histologic appearances of endoscopic gastric mucosal biopsies 10--20 years after partial gastrectomy

Fifty-six symptomatic patients, who had had a partial gastrectomy 10--24 years previously for benign disease, were examined by endoscopy and multiple mucosal biopsies. No patient had a completely normal gastric mucosa. Varying degrees of gastritis, intestinal metaplasia, foveolar hyperplasia and dysplasia were seen. Seventeen patients (30%) had extensive areas of dysplasia associated with acute or chronic inflammation. Severe dysplasis, however, was detected in only one case. In five patients a "diffuse type" carcinoma of the gastric stump was found. While it is generally accepted that significant dysplasia (moderate or severe dysplasis) is premalignant, the degree of risk is unknown. This makes management of individual patients difficult.