Increased risk of biliary tract cancer following gastric surgery.

Analysis of 4,466 peptic ulcer patients, who had undergone gastric surgery at least 25 years previously, showed no change in risk from biliary tract cancer within the first 20 years, but a 9.4 fold (P less than 0.001) excess risk thereafter. The increased risk was 15.8 fold (P less than 0.001) 20 years after operation for gastric ulcer patients and 5.1 fold (NS) in duodenal ulcer patients. When the risk was analysed by subsite it was found that there was no increased risk at any time after operation for cancer of the bile duct, and that all of the excess risk 20 or more years after operation (14.7 fold; P less than 0.001) was for cancer of the gallbladder.