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Retrospective Analysis on the Gallstone Disease after Gastrectomy for Gastric Cancer.

Jun KH, Kim JH, Kim JJ, Chin HM, Park SM - Gastroenterol Res Pract (2015)

Bottom Line: Roux-en-Y reconstruction and lymph node dissection in the hepatoduodenal ligament were associated with a significantly higher incidence.Conclusions.Only a few postoperative complications after subsequent cholecystectomy occurred, even when using a laparoscopic approach.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul 442-723, Republic of Korea.

ABSTRACT
Background. The aim of this study is to evaluate the incidence of gallstone after gastrectomy, risk factors for gallstone formation, and the surgical outcome of cholecystectomy after gastrectomy. Methods. A total of 2480 gastric cancer patients who underwent curative resection at two institutions between January 1997 and December 2012 were retrospectively reviewed. The patients' age, gender, diabetes mellitus, type of gastrectomy, extent of node dissection, and type of reconstruction were evaluated. Results. Gallstone formation occurred in 128 of 2480 (5.2%) patients who had undergone gastrectomy for gastric cancer. The incidence of gallstones was significantly higher after total compared with subtotal gastrectomy. Roux-en-Y reconstruction and lymph node dissection in the hepatoduodenal ligament were associated with a significantly higher incidence. In multivariate analysis, diabetes mellitus and reconstruction method were identified as significant risk factors for gallstone development. The proportion of silent stone was higher in the laparoscopic cholecystectomy (LC) group than in the open cholecystectomy (OC) group. Operation time and hospital stay were shorter in the LC group than in the OC group. Conclusions. Diabetes mellitus and Roux-en-Y reconstruction are risk factors for gallstones after gastrectomy. Only a few postoperative complications after subsequent cholecystectomy occurred, even when using a laparoscopic approach.

No MeSH data available.


Related in: MedlinePlus

Patient enrollment and outcomes.
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Related In: Results  -  Collection


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fig1: Patient enrollment and outcomes.

Mentions: We enrolled 2875 patients who underwent curative gastric cancer surgery at the Department of Surgery, Incheon St. Mary's Hospital and St. Vincent's Hospital, The Catholic University of Korea between January 1997 and December 2012. Exclusion criteria were (1) previous cholecystectomy (n = 41), (2) prophylactic cholecystectomy (n = 310), (3) remnant gastric cancer (n = 31), and (4) mortality within 30 days after surgery (n = 13) (Figure 1). After applying these criteria, a total of 2480 patients were included in this study. All 2480 cases involved either total gastrectomy or distal gastrectomy associated with systemic lymph node dissection. Open gastrectomy was performed in 1488 cases and laparoscopic gastrectomy was performed in 992 cases. Lymph node dissection and TNM staging were performed following the guidelines of the Japanese Research Society for Gastric Cancer (JRSGC) [13]. Every patient underwent vagotomy associated with gastrectomy and lymph node dissection. Intestinal reconstruction was performed using Roux-en-Y method for total gastrectomy and Billroth I or II anastomosis or Roux-en-Y reconstruction for distal gastrectomy. The patients were followed for a median of 91.6 (range, 15–206) months. Data from these patients were entered into a prospectively maintained database. The Institutional Review Boards of Incheon St. Mary's Hospital (OC14RIMI0034) and St. Vincent's Hospital (VC14RIMI0046) approved the study protocol.


Retrospective Analysis on the Gallstone Disease after Gastrectomy for Gastric Cancer.

Jun KH, Kim JH, Kim JJ, Chin HM, Park SM - Gastroenterol Res Pract (2015)

Patient enrollment and outcomes.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4477116&req=5

fig1: Patient enrollment and outcomes.
Mentions: We enrolled 2875 patients who underwent curative gastric cancer surgery at the Department of Surgery, Incheon St. Mary's Hospital and St. Vincent's Hospital, The Catholic University of Korea between January 1997 and December 2012. Exclusion criteria were (1) previous cholecystectomy (n = 41), (2) prophylactic cholecystectomy (n = 310), (3) remnant gastric cancer (n = 31), and (4) mortality within 30 days after surgery (n = 13) (Figure 1). After applying these criteria, a total of 2480 patients were included in this study. All 2480 cases involved either total gastrectomy or distal gastrectomy associated with systemic lymph node dissection. Open gastrectomy was performed in 1488 cases and laparoscopic gastrectomy was performed in 992 cases. Lymph node dissection and TNM staging were performed following the guidelines of the Japanese Research Society for Gastric Cancer (JRSGC) [13]. Every patient underwent vagotomy associated with gastrectomy and lymph node dissection. Intestinal reconstruction was performed using Roux-en-Y method for total gastrectomy and Billroth I or II anastomosis or Roux-en-Y reconstruction for distal gastrectomy. The patients were followed for a median of 91.6 (range, 15–206) months. Data from these patients were entered into a prospectively maintained database. The Institutional Review Boards of Incheon St. Mary's Hospital (OC14RIMI0034) and St. Vincent's Hospital (VC14RIMI0046) approved the study protocol.

Bottom Line: Roux-en-Y reconstruction and lymph node dissection in the hepatoduodenal ligament were associated with a significantly higher incidence.Conclusions.Only a few postoperative complications after subsequent cholecystectomy occurred, even when using a laparoscopic approach.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul 442-723, Republic of Korea.

ABSTRACT
Background. The aim of this study is to evaluate the incidence of gallstone after gastrectomy, risk factors for gallstone formation, and the surgical outcome of cholecystectomy after gastrectomy. Methods. A total of 2480 gastric cancer patients who underwent curative resection at two institutions between January 1997 and December 2012 were retrospectively reviewed. The patients' age, gender, diabetes mellitus, type of gastrectomy, extent of node dissection, and type of reconstruction were evaluated. Results. Gallstone formation occurred in 128 of 2480 (5.2%) patients who had undergone gastrectomy for gastric cancer. The incidence of gallstones was significantly higher after total compared with subtotal gastrectomy. Roux-en-Y reconstruction and lymph node dissection in the hepatoduodenal ligament were associated with a significantly higher incidence. In multivariate analysis, diabetes mellitus and reconstruction method were identified as significant risk factors for gallstone development. The proportion of silent stone was higher in the laparoscopic cholecystectomy (LC) group than in the open cholecystectomy (OC) group. Operation time and hospital stay were shorter in the LC group than in the OC group. Conclusions. Diabetes mellitus and Roux-en-Y reconstruction are risk factors for gallstones after gastrectomy. Only a few postoperative complications after subsequent cholecystectomy occurred, even when using a laparoscopic approach.

No MeSH data available.


Related in: MedlinePlus