Absence of Gastric and Esophageal Carcinoma After MGB-OAGB



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 


  1. 1.
    Clark CG, Fresni A, Gledhill T. Cancer following gastric surgery. Br J Surg. 1985;72:591–4.CrossRefGoogle Scholar
  2. 2.
    Luukkonen P, Kalima T, Kivilaako E. Decreased risk of gastric stump carcinoma after partial gastrectomy. Hepato-Gastroenterology. 1990;37:392–4.PubMedGoogle Scholar
  3. 3.
    Bassily R, Smallwood RA, Crotty R. Risk of gastric cancer is not increased after partial gastrectomy. J Gastroenterol Hepatol. 2000;15:762–5.CrossRefGoogle Scholar
  4. 4.
    Lagergren J, Lindam A. The risk of oesophageal adenocarcinoma after gastrectomy for peptic ulcer disease. Eur J Cancer. 2012;48:749–52.CrossRefGoogle Scholar
  5. 5.
    Schafer LW, Larson DE, Melton LJ III. The risk of gastric carcinoma after surgical treatment for benign ulcer disease: a population-based study in Olmsted County. N Engl J Med. 1983;309:1210–3.CrossRefGoogle Scholar
  6. 6.
    Fromm D. Postgastrectomy syndrome. In: Zuidema GD, editor. Shackelford’s surgery of the alimentary tract, vol. Vol II. 3rd ed. Philadelphia: W.B. Saunders; 1991. p. 174.Google Scholar
  7. 7.
    Frantz JD, Bretton G, Cartwright ME, et al. Proliferative lesions of the non-glandular and glandularstomach of rats. In: Guides for toxicologic pathology STP/ARF/AFIP, Washington, DC; 1991.Google Scholar
  8. 8.
    Proctor DM, Gatto NM, Hong SJ, Allamneni KP. Mode-of-action framework for evaluating the relevance of rodent forestomach tumors in cancer risk assessment. Toxicol Sci. 2007;98(2):313–26.CrossRefGoogle Scholar
  9. 9.
    Chandra SA, Nolan MW, Malarkey DE. Chemical carcinogenesis of the gastrointestinal tract in rodents; an overview with emphasis on NTP carcinogenesis bioassays. Toxicol Pathol. 2010;38:188–97.CrossRefGoogle Scholar
  10. 10.
    Felsenreich DM, Kefurt R, Schermann M, et al. Reflux, sleeve dilation, and Barrett’s esophagus after laparoscopic sleeve gastrectomy: long-term follow-up. Obes Surg. 2017;27(12):3092–101.CrossRefGoogle Scholar
  11. 11.
    Karuba R, Jawad M, Karl RC, et al. Technique of resection of esophageal adenocarcinoma after Roux-en-Y gastric bypass and literature review of esophagogastric tumors after bariatric procedures. Surg Obes Relat Dis. 2009;5:576–81.CrossRefGoogle Scholar
  12. 12.
    Scozzari G, Trapani R, Toppino M, Morino M. Esophagogastric cancer after bariatric surgery: systematic review of the literature. Surg Obes Relat Dis. 2013;9:133–42.CrossRefGoogle Scholar
  13. 13.
    Nau P, Rattner DW, Meireles O. Linitus plastica presenting two years after elective Roux-en-Y gastric bypass for treatment of morbid obesity: a case report and review of the literature. Surg Obes Relat Dis. 2014;10(2):e15–7.CrossRefGoogle Scholar
  14. 14.
    Angrisani L, Santonicola A, Iovino P. Gastric cancer: a de novo diagnosis after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2014;10:186–7.CrossRefGoogle Scholar
  15. 15.
    van de Vrande S, Himpens J, Leman G. Adenocarcinoma of the gastric pouch after Roux-en-Y gastric bypass: a new technique for en bloc resection and reconstruction. Surg Obes Relat Dis. 2017;13:1793–5.CrossRefGoogle Scholar
  16. 16.
    Mion F, Tolone S, Garros A, et al. High-resolution impedance manometry after sleeve gastrectomy: increased intragastric pressure and reflux are frequent events. Obes Surg. 2016;26:2449–56.CrossRefGoogle Scholar
  17. 17.
    Braghetto I, Csendes A. Prevalence of Barrett’s esophagus in bariatric patients undergoing sleeve gastrectomy. Obes Surg. 2016;26(4):710.CrossRefGoogle Scholar
  18. 18.
    Saber AA, Shoar S, Khoursheed M. Intra-thoracic sleeve migration (ITSM): an underreported phenomenon after laparoscopic sleeve gastrectomy. Obes Surg. 2017;27:1917–23.CrossRefGoogle Scholar
  19. 19.
    Naslund E, Stockeld D, Granstrom L, et al. Six cases of Barrett’s esophagus after gastric restrictive surgery for massive obesity: an extended case report. Obes Surg. 1996;6:155–8.CrossRefGoogle Scholar
  20. 20.
    Tolone S, Cristiano S, Savarino E, et al. Effects of omega-loop bypass on esophagogastric junction function. Surg Obes Relat Dis. 2016;12:62–9.CrossRefGoogle Scholar
  21. 21.
    Wu CC, Lee WJ, Ser KH, Chen JC, Tsou JJ, Chen SC, Kuan WS. Gastric cancer after mini-gastric bypass surgery: a case report. Asian J Endosc Surg. 2013;6:303–6.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Editor-in-Chief Emeritus & Founding Editor, Obesity Surgery; Founding Member ASMBS and IFSO; Past-President ASMBS; Director MGB-OAGB ClubTorontoCanada

Personalised recommendations