[Carcinoma after gastric operations (author's transl)]

The incidence of carcinoma after gastric operations for benign lesions was analysed in the patient material of five gastroenterologists in private practice in Switzerland. Of 534 such patients 346 had had a gastric resection with gastrojejunostomy (Billroth II), 58 with gastroduodenostomy (Billroth I), and 130 other kinds of gastric operations. Among 326 patients who had a Billroth II procedure there were 21 with proven carcinoma in the residual stomach, but none after Billroth I and other operations. The incidence after Billroth II was 15.1% at or after ten years. Of 69 patients 10-19 years after gastric resection, six had developed carcinoma, compared with 15 of 70 who were 20 years or more after the resection. The incidence is unexpectedly high. On the other hand, among 29361 non-operated patients there were 279 with carcinoma of the stomach. The average interval between operation and the diagnosis of carcinoma in the residual stomach was 23.8 years. It is recommended that gastric resection should if possible be avoided for benign disease. All patients who have had a gastric resection should be endoscopically controlled annually from ten years after the resection onwards.