A Case of Gastric Cancer after Choledochoduodenostomy and Gastrojejunostomy

Nobutaka Tanaka, Masakazu Nobori, Yasushi Harihara, Shunya Shindo, Shigeki Saiki*

Department of Surgery, Asahi General Hospital
*Division of Pathology, S't Lukes International Hospital

A case of gastric cancer in a 63-year-old man is reported. The patient had received a cholecystectomy for gallstones 22 years previously, and a choledochoduodenostomy and gastrojejunostomy with Braun's anastomosis for common bile duct stones 10 years later. The gastric cancer was a depressed type of early cancer, located at the gastric angle, and was histologically diagnosed as moderately differentiated adenocarcinoma. The gastric mucosa surrounding the cancer was characterized by marked intestinal metaplasia and atrophic gastritis. The stomach was partially resected and reconstructed with a Roux-Y gastrojejunostomy. The patient has been well for nine years. This is probably the first reported case of gastric cancer after gastrojejunostomy among gallstone diseases in Japan. The present case seems to lend support to the duodeno-gastric reflux theory that bile and duodenal juice resulting from cholecystectomy, choledochoduodenostomy and gastrojejunostomy, is carcinogenic in the stomach.

Key words
gastric cancer after gastrojejunostomy, gastric cancer after cholecystectomy, duodenogastric reflux

Reprint requests
Nobutaka Tanaka Department of Surgery, Asahi General Hospital
1326 Asahi City, Chiba, 289-25 JAPAN

Accepted
December 12, 1990

To read the PDF file you will need Abobe Reader installed on your computer.