Eberlein T J, Lorenzo F V, Webster M W
Ann Surg. 1978 Mar;187(3):251-6. doi: 10.1097/00000658-197803000-00007.
Gastric carcinoma following operation for benign peptic ulcer disease has been considered rare but nine patients have been seen during the past five years. All were male patients, the average time interval from prior ulcer operation to development of cancer was 17 years, but was a short as ten years. The symptoms of cancer are vague and the diagnosis is often delayed. Fiberoptic endoscopy with biopsy of suspicious areas is the most accurate diagnostic approach. Resection of the tumor is indicated if feasible. The poor prognosis of this malignancy is documented. The evidence is reviewed that the creation of achlorhydria with bile reflux increases the risk of development of gastric carcinoma. All patients who undergo peptic ulcer operation require careful long-term follow-up. Vague gastrointestinal symptoms occurring ten years or more after peptic ulcer operation require full evaluation to exclude the presence of gastric cancer.
良性消化性溃疡病手术后发生的胃癌一直被认为较为罕见，但在过去五年中已发现9例。所有患者均为男性，从先前溃疡手术到癌症发生的平均时间间隔为17年，但最短为10年。癌症症状不明确，诊断往往延迟。纤维内镜检查并对可疑区域进行活检是最准确的诊断方法。如果可行，应进行肿瘤切除。这种恶性肿瘤预后不良已有记录。有证据表明，胃酸缺乏伴胆汁反流会增加胃癌发生的风险。所有接受消化性溃疡手术的患者都需要进行仔细的长期随访。消化性溃疡手术后十年或更长时间出现的不明确胃肠道症状需要进行全面评估，以排除胃癌的存在。
