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Gastric cancer after Bariatric Bypass Surgery. Do they relate? (A Systematic Review)

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Abstract

Bariatric bypass surgery has been an effective treatment for morbid obesity. However, there is an increasing number of reported cases of gastric cancer after bypass surgery. Our systematic review showed an increasing trend of gastric cancer cases after bariatric bypass surgery in the last decade, mostly located in the excluded stomach (77%) and diagnosed in an advanced stage. In addition to known risk factors such as tobacco smoking (17%), H. pylori infection (6%), and family history of gastric cancer (3%), bile reflux, a recently proposed cancer-promoting factor, was also estimated in 18% of the cases. Our data suggest that gastric cancer risk assessment should be considered before gastric bypass surgery, and further investigations are needed to determine the value of post-operative gastric cancer surveillance.

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Data Availability

The datasets used and/or analyzed during the current study are available in the supplementary material.

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Authors and Affiliations

  1. Department of Medicine, Division of Gastroenterology and Hepatology, Saint Peter’s University Hospital/Rutgers-RWJ Medical School, 254 Easton Avenue, New Brunswick, NJ, 08901, USA

    Sotirios G. Doukas & Arkady Broder

  2. Departmengt of Surgery, Yale University School of Medicine, New Haven, CT, 06510, USA

    Panagiotis G. Doukas & Dimitra P. Vageli

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  1. Sotirios G. Doukas
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  3. Dimitra P. Vageli
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Contributions

SGD, PGD, DPV and AB were involved in conceiving and designing the study. SGD and DPV-PGD contributed to data collection. DPV, SGD, PGD, and AB contributed to the interpretation of data. DPV, PGD, and SGD are involved in the preparation of the original draft. SGD, PGD, DPV, and AB critically revised the manuscript. All authors have read and approved the last version of the manuscript.

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Correspondence to Sotirios G. Doukas.

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Key points

• The reported cases of gastric cancer post-gastric bypass have increased.

• Gastric cancer after a bariatric bypass is often found in the excluded stomach.

• Gastric cancer risk assessment is recommended before gastric bypass surgery.

• Prospective studies could reveal the impact of post-surgical risk factors like bile.

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Doukas, S.G., Doukas, P.G., Vageli, D.P. et al. Gastric cancer after Bariatric Bypass Surgery. Do they relate? (A Systematic Review). OBES SURG 33, 1876–1888 (2023). https://doi.org/10.1007/s11695-023-06567-6

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  • DOI: https://doi.org/10.1007/s11695-023-06567-6

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