A differentiated approach to selecting candidates for gastric bypass among patients with atrophy of the gastric mucosa

It is known that weight loss after bariatric surgery is accompanied by a decrease in the risk of developing a number of cancer pathologies. However, gastric cancer deserves special attention, which in most cases is associated with Helicobacter pylori (H. pylori) infection, atrophy and intestinal metaplasia. When a patient undergoes gastric bypass, it is necessary to understand that most of the stomach, in which oncological transformation can begin, is no longer subject to visual endoscopic assessment, and therefore, for such patients, identifying early gastric cancer becomes impossible. The article discusses the risks of developing malignant neoplasms in patients with H. pylori-associated gastritis, autoimmune gastritis, atrophy and intestinal metaplasia, and also proposes a differentiated approach to the choice of gastric bypass as a bariatric operation in such patients.