• Skip to primary navigation
  • Skip to main content

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • Leadership
    • SAGES Mission Statement
    • Advocacy
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • SAGES Store
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
    • “Unofficial” Logo Products
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2026 Scientific Session Call For Abstracts
      • 2026 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
    • Future Meetings
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Join the SAGES Patient Partner Network (PPN)
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • Sustainability in Surgical Practice
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • Wellness Resources – You Are Not Alone
    • OpiVoid.org
    • SAGES Video Subscription
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Free Webinars For Residents
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Fluorescence-Guided Surgery Course for Fellows
    • Fellows Career Development Course
    • Robotics Fellows Course
    • MIS Fellows Course
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES Top 21 MIS Procedures
    • SAGES Pearls
    • SAGES Flexible Endoscopy 101
    • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy
    • SAGES Fellowship Recognition Opportunities
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • OWLS / FLS
  • Log In

Adenocarcinoma in Gastric Remnant After Gastric Roux-en-Y Bypass Surgery for Morbid Obesity: A Case Report

Alejandro Garza, MD, Robert Alleyn, MD, Jose Almeda, MD, Ricardo Martinez, MD. UTRGV

Obesity is an epidemic condition worldwide carrying significant morbidity and mortality. Surgical therapy is the only proven effective method to sustain weight loss. Among the different surgical procedures gastric bypass is the most effective. During this surgery, most of the stomach is excluded from the upper gastrointestinal tract which makes future evaluation of the same very challenging. This could potentially lead to delay in diagnosis of any pathology in the bypass stomach. Gastric Cancer is the 14th most common cause of cancer and cause of cancer death in the United States.

We present a case report of a patient who underwent a Roux-en-Y gastric bypass and went on to developed adenocarcinoma in the gastric remnant 28 year after her surgery. She underwent an exploratory laparotomy, extended antrectomy, subtotal gastrectomy including the gastro-colic ligament, and incidental appendectomy. Pathology showed grade 4 undifferentiated adenocarcinoma that penetrated the visceral peritoneum with clear margins. There was angiolymphatic invasion and perineural invasion along with metastatic carcinoma in 5 out of 6 lymph nodes. Patient received adjuvant chemotherapy. The patient continues to be in clinical and radiological remission 3 years after her diagnosis. 

There are multiple risk factors for the development of gastric cancer in general. Infection of the gastric mucosa by Helicobacter pylori, which can cause inflammation and result in a pre-malignant lesion. It is one of the most clinically relevant factors because it can be treated before neoplastic changes occurs. Other risk factors include a family history, low fruit and vegetable consumption, obesity, smoking, and previous gastric surgeries.

Due to the surgical anatomic changes, inherent to the Roux N Y Gastric Bypass it is technically difficult to monitor and evaluate the remnant stomach with upper endoscopy which highlights the importance of pre-operative evaluation. There are different non–surgical methods to evaluate the remnant stomach besides any abdominal CT scan. These include radiographic techniques with percutaneous contrast injection, placement of a gastrostomy tube for later access , as well as retrograde endoscopy with a pediatric colonoscope or a double-balloon enteroscope.

According to the literature there are only 8 cases reported of malignancy arising in the remnant stomach after bypass surgery. Due to the low incidence, this case is reported to help physicians carry a high level of clinical suspicion in these patients.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 86696

Program Number: P172

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

248

Share this:

  • Click to share on X (Opens in new window) X
  • Click to share on X (Opens in new window) X
  • Click to share on Facebook (Opens in new window) Facebook
  • Click to share on LinkedIn (Opens in new window) LinkedIn
  • Click to share on Pinterest (Opens in new window) Pinterest
  • Click to share on WhatsApp (Opens in new window) WhatsApp
  • Click to share on Reddit (Opens in new window) Reddit
  • Click to share on Pocket (Opens in new window) Pocket
  • Click to share on Mastodon (Opens in new window) Mastodon

Related



  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2025 Society of American Gastrointestinal and Endoscopic Surgeons