Incidence and clinical features of endoscopic ulcers developing after gastrectomy

Table 1 Comparison of patients with and without endoscopic ulcers following gastrectomy

	Patients withendoscopic ulcersafter gastrectomy(n = 78)	Patients withoutendoscopic ulcersafter gastrectomy(n = 759)	P value
Age (yr)	62.26 ± 12.89	61.00 ± 12.50	0.92
Gender (male/female)	59:19	523:236	0.20
Anastomosis
Billroth-I	12	237	< 0.01
Billroth-II	63	477
Other method	3	45
Causative diseases
Malignancy	31	645	< 0.01
Complication of PUD	44	102
Others	3	12
H. pylori infection (%)	20/58 (34.5)	145/397 (36.5)	0.76

H. pylori: Helicobacter pylori; PUD: Peptic ulcer disease.

Table 2 Comparison of marginal ulcers according to the location

	Ulcers on theefferent side(n = 36)	Both(n = 4)	Ulcers atanastomosis(n = 32)
Age (yr)	63.45 ± 14.03	62.50 ± 10.25	61.15 ± 12.49
Sex (male/female)	26:10	2:2	25:7
Tobacco use	15	2	10
Alcohol consumption	14	2	12
Clinical symptoms
Bleeding episode	6	1	10
Anemia evaluation	9	2	2
Abdominal pain	11	1	10
Dyspepsia	5	0	5
Routine check	5	0	5
Anastomosis
Billroth-I	7	0	6
Billroth-II	27	4	25
Total gastrectomy with RY	1	0	0
Whipple	1	0	1
Causative disease
Malignancy	14	1	16
Complication of PUD	20	3	15
Others	2	0	1
Ulcer multiplicity	15	4	6
Number of therapeutic intervention	5	1	8
Initial hemoglobin (g/dL)	9.70 ± 3.38	6.70 ± 2.53	9.87 ± 3.79
Admission	21	4	1
Ulcer recurrence	12	2	7
H. pylori infection (%)	7/25 (28)	1/2 (50)	8/25 (32)

RY: Roux-en-Y anastomosis; H. pylori: Helicobacter pylori; PUD: Peptic ulcer disease.

Table 3 Comparison of marginal ulcers according to causative disease

	Marginal ulcersin patients witha history of PUD(n = 38)	Marginal ulcers inpatients withouta history of PUD(n = 34)	P value
Age (yr)	62.87 ± 13.67	63.47 ± 13.03	0.85
Sex (male/female)	31:7	22:12	0.10
Anastomosis
B-I/B-II/others	3/35/0	6/25/3	0.06
Clinical symptoms
Bleeding episode	10	7	0.04
Severe anemia	10	3
Location
Efferent side/ anastomosis/both	20/15/3	16/17/1	0.50
Initial hemoglobin (g/dL)	8.83 ± 2.83	11.04 ± 3.73	0.03
Admission (case)	25	13	0.01
Rebleeding during admission	4	3	0.87
Ulcer recurrence	9	11	0.41
H. pylori infection (%)	9/25 (36)	7/24 (29.2)	0.61

H. pylori: Helicobacter pylori; PUD: Peptic ulcer disease; B: Billroth.

Table 4 Case profile of gastric stump cancer

Case number	1	2	3	4	5	6
Sex	M	M	M	M	M	M
Age (yr)	73	73	58	61	61	44
Tobacco use	Yes	Yes	No	No	Yes	No
Alcohol consumption	No	Yes	No	No	No	No
Anastomosis	B-II	B-I	B-I	B-I	B-II	B-II
Latency period (mo)	360	480	360	152	432	228
Reason for operation	Pyloric obstruction	GU perforation	GU bleeding	Pyloric obstruction	GU perforation	DU perforation
Chief complaint	Melena	Soreness	Pain	Routine	Pain	Pain
Tumor location	Anastomosis	Anastomosis	Stump	Stump	Stump	Stump
Tumor type	Adenoca	Adenoca	Adenoca	Adenoca	Adenoca	Adenoca
Differentiation	Moderate	Poor	Poor	Poor	Moderate	Poor
H. pylori infection	Negative	Negative	Positive	Positive	Positive	Negative
TNM stage
T	T4a	T3	T3	T2b	pT3	T3
N	N2	N0	N0	N1	N1	N0
M	M1 (Liver)	M0	M0	M0	M0	M0
Treatment	None	Total gastrectomy	Total gastrectomy	Total gastrectomy	Total gastrectomy	Total gastrectomy
Survival (mo)	No (3)	No (10)	No (10)1	Yes (36)	No (8)	No (18)
DFS (mo)	No (0)	Yes (9)	Yes (10)	Yes (36)	No (0)	Yes (15)

¹Expired due to leukopenia and pneumonia. GU: Gastric ulcer; DU: Duodenal ulcer; Adenoca: Adenocarcinoma; DFS: Disease-free survival; H. pylori: Helicobacter pylori; B: Billroth.