By reviewing the whole process of multi-disciplinary treatment (MDT) for elderly patients with gastric cancer complicated with gastrointestinal obstruction and bleeding in our center, the principles of surgical diagnosis and treatment for elderly patients with gastric cancer were summarized and discussed.

Based on a patient admitted to the Department of Oncological Laparoscopic Surgery, the First Affiliated Hospital of Harbin Medical University in Apr. 2025, who was clinically diagnosed as gastric cancer with gastrointestinal bleeding and pyloric obstruction in the recent examination due to melena and severe vomiting after eating. By starting MDT diagnosis and treatment mode, the patient′s preoperative general status and systemic organ reserve function were evaluated, and the minimally invasive surgical treatment strategy was formulated after digestive endoscopy and tumor staging evaluation.

The patient successfully underwent laparoscopic radical gastrectomy D2 (distal gastrectomy+ Billroth Ⅱ anastomosis+ intestinal anastomosis). The operation time was about 3 hours, and the amount of bleeding was about 50ml. There was no postoperative infection, bleeding, anastomotic leakage, gastrointestinal dysfunction, thrombosis and other complications. Postoperative pathological examination showed gastric ulcer moderately to poorly differentiated adenocarcinoma (T3N0MX).

Elderly patients with gastric cancer should start the MDT diagnosis and treatment mode immediately after admission, carry out rigorous and comprehensive preoperative evaluation of their systemic organ reserve function, formulate precise perioperative preparation plan, and treat the tumor and its complications through minimally invasive surgery, so that patients can finally achieve maximum benefits.