Since 1997, >55,000 MGB-OAGBs have been performed. There had been concern about bile in stomach and esophagus causing CA. After the old Billroth II, long-term studies have shown actual decrease in development of CA (although H. pylori was unknown and untreated). Also, no CA of stomach has been reported after the old vagotomy & pyloroplasty for peptic ulcer.
Studies of bile preparation in the rat’s stomach show hyperplasia and neoplasia in the proximal two-thirds (rat forestomach—which is squamous cell), but not in the distal third (which is glandular like the human stomach).
Following bariatric operations, 39 CAs have been reported in stomach and esophagus: Mason horizontal loop gastric bypass 4, RYGB 15, VBG 10, Lap-band 6, and recently sleeve gastrectomy 2 (which is frequently followed by Barrett’s esophagus).
After MGB, only one CA has been reported—9 years postoperatively in Taiwan (where CA of stomach is very common) by Wei-Jei Lee, which occurred in the bypassed stomach but not in the pouch.
CA after MGB is exceedingly rare.
Carcinoma of stomach and esophagus Bariatric surgery RYGB Gastric banding VBG SG MGB-OAGB
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