Gastric carcinoma after peptic ulcer surgery.

Gastric carcinoma following surgery for benign peptic ulcer disease is being increasingly reported. The authors have reviewed their experience at Saint Francis Hospital and Medical Center and Mount Sinai Hospital from 1970 to 1980 and found 319 cases of gastric carcinoma, 16 of whom had undergone previous surgical procedures for peptic ulcer disease, with an incidence of 5 per cent of gastric stump carcinoma. The average time interval for the development of gastric stump carcinoma was 17.4 years, ranging from 5 to 49 years. The average survival after the diagnosis was 4.6 months, making the prognosis uniformly poor, probably due to delayed diagnosis. Treatment modalities consisted of major and minor surgical procedures, medical therapy, and no treatment in some instances. It is recommended that all patients who undergo operations for peptic ulcers have careful long-term follow-up. Vague gastrointestinal symptoms occurring in these patients, especially 10 years or more after surgery, require endoscopy and biopsies of the gastric stump to exclude gastric stump carcinoma.