Analysis of risk factors for the development of gallstones after gastrectomy

Background: The incidence of gallstones is higher in people who have undergone gastrectomy than in the general population, but the cause of this is unknown. Methods: Between January 1992 and January 2003, 749 patients underwent ultrasonography of the gallbladder after gastrectomy for gastric cancer....

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Bibliographic Details
Published in:British journal of surgery 2005-11, Vol.92 (11), p.1399-1403
Main Authors: Kobayashi, T., Hisanaga, M., Kanehiro, H., Yamada, Y., Ko, S., Nakajima, Y.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Female
Gallstones - epidemiology
Gallstones - etiology
Gastrectomy - adverse effects
Gastroenterology. Liver. Pancreas. Abdomen
General aspects
Humans
Incidence
Japan - epidemiology
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Male
Medical sciences
Middle Aged
Other diseases. Semiology
Risk Factors
Stomach Neoplasms - epidemiology
Stomach Neoplasms - surgery
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Summary:Background: The incidence of gallstones is higher in people who have undergone gastrectomy than in the general population, but the cause of this is unknown. Methods: Between January 1992 and January 2003, 749 patients underwent ultrasonography of the gallbladder after gastrectomy for gastric cancer. A total of 2327 examinations were carried out. The incidence of gallstones was compared in subgroups of patients classified according to the type of reconstruction, extent of gastrectomy, whether the duodenum was excluded and type of lymph node dissection. Results: The incidence of gallstones was significantly higher after total compared with partial gastrectomy (27·9 versus 7·8 per cent at 5 years; P < 0·001). Reconstruction with duodenal exclusion was associated with a significantly higher incidence than non‐exclusion (25·1 versus 8·2 per cent at 5 years; P < 0·001). Patients who had lymph node dissection in the hepatoduodenal ligament had a significantly higher incidence of gallstones than those who did not (28·2 versus 7·5 per cent at 5 years; P < 0·001). In multivariate analysis that included type of reconstruction and lymph node dissection, lymph node dissection in the hepatoduodenal ligament was identified as the most significant risk factor for gallstone development (odds ratio 3·66 (95 per cent confidence interval 2·16 to 6·22); P < 0·001). Conclusion: Lymph node dissection in the hepatoduodenal ligament, total gastrectomy and exclusion of the duodenum are risk factors for gallstones after gastrectomy. Copyright © 2005 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Depends on type of operation
ISSN:0007-1323
1365-2168
DOI:10.1002/bjs.5117