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Open Access

The primary gastric stump cancer in geriatric patients

  • Bledar Koltraka1,
  • Eriberto Farinella1,
  • Ivan Barillaro1,
  • Roberto Cirocchi1,
  • Alban Cacurri1,
  • Francesco Barillaro1,
  • Stefano Trastulli1,
  • Micol Sole Di Patrizi1,
  • Gianmario Giustozzi1 and
  • Francesco Sciannameo1
BMC Geriatrics20099(Suppl 1):A84

Published: 1 April 2009


Gastric CancerLymph Node DissectionHistological FeatureTotal GastrectomySynergic Action


The pathophysiology of gastric stump cancer is due to the synergic action between multiple factors including the duodenogastric biliary reflux and bacterial colonization of the stump. The histological features of this cancer are not different from cancer that arises in normal stomach.

In this study we present our experience in order to analyze the importance of early treatment of gastric stump cancer in geriatric patients.


The authors present 7 cases of primary gastric stump cancer surgically treated in our department during the period 1999–2002. The age of patients was between 61 and 79 years. The average time between primary gastric resection and diagnosis of carcinoma of gastric stump was 19 years (6–32 years). All patients considered operable underwent total gastrectomy and restoration of intestinal transit according to Roux's technique.


Four patients (57.14%) were resectable, including 3 aged over 70 years. In all cases total gastrectomy with systematic D2 lymphadenectomy was performed. In the remaining patients who did not undergo gastrectomy, 2 patients were treated with exploratory laparotomy because of very advanced and unresectable gastric cancer, and 1 patient was not suitable for surgical treatment as his general conditions were poor. The 5-year survival rate in patients resected was 50%.


Our series of 7 cases of carcinoma of the gastric stump highlights the importance of endoscopic investigations during the follow-up of patients with gastric resection, especially after 15 years, and of radical surgery (total gastrectomy with D2 lymph node dissection) in geriatric patients.

Authors’ Affiliations

Department of General and Emergency Surgery, S. Maria Hospital, Terni-University of Perugia, Italy


© Koltraka et al; licensee BioMed Central Ltd. 2009

This article is published under license to BioMed Central Ltd.