Gastric adenocarcinoma in the excluded stomach after Roux-en-Y gastric bypass: a case series, systematic review, and diagnostic algorithm.
Ikttesh Chahal, Wade Hopper, Audra King et al.
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From the abstract
Primary remnant gastric cancer after Roux-en-Y gastric bypass presents a diagnostic challenge, and no consensus indications exist to guide the evaluation of the excluded anatomy when malignancy is suspected.
Reported results
A total of 55 patients with remnant gastric cancer were identified (7 institutional and 48 from the literature). The median time from gastric bypass to diagnosis was 15 years, and most patients had an advanced tumor stage. Before diagnosis, 24 patients (45%) had documented anemia, and 42 patients (78%) had abnormalities of the excluded stomach on cross-sectional imaging.
Authors' conclusions
Anemia and radiographic evidence of excluded stomach abnormalities are both common among patients eventually diagnosed with remnant gastric cancer, and either of these findings should prompt consideration of accessing excluded anatomy.