Gastric cancer after bariatric surgery –⁠ a diagnostic challenge

Czech version

Authors: E. Rada; Z. Adamová; M. Chrostek
Authors‘ workplace: Chirurgické oddělení, Moravskoslezská nemocnice Frýdek-Místek, p. o.
Published in: Rozhl. Chir., 2026, roč. 105, č. 3, s. 123-127.
Category: Case Report
doi: https://doi.org/10.48095/ccrvch2026123

Overview

Introduction: Bariatric surgery is an effective treatment for severe obesity, offering substantial improvements in patients’ metabolic profiles. However, increasing attention is being paid to potential long-term complications, including malignancies developing in the excluded portion of the stomach –⁠ an area that poses significant diagnostic challenges.

Case report: We report the case of a 68-year-old woman with a history of biliopancreatic diversion, who was diagnosed with advanced diffuse gastric carcinoma 10 years after surgery. The clinical presentation was non-specific, and both laboratory and imaging studies repeatedly yielded false-negative results. A definitive diagnosis was established only during diagnostic laparoscopy –⁠ unfortunately, at a stage too advanced for curative treatment.

Conclusion: This case underscores the risk of late-onset malignancy in the excluded stomach following bariatric surgery and highlights the considerable diagnostic difficulties. Early detection requires a high index of clinical suspicion, access to advanced endoscopic techniques, and close multidisciplinary collaboration. The absence of standardized screening protocols further hampers timely diagnosis.

Keywords:

Gastric cancer – biliopancreatic diversion – bariatric surgery – excluded stomach

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