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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

Incidence of gallstones after gastrectomy.
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Related In: Results  -  Collection


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fig2: Incidence of gallstones after gastrectomy.

Mentions: The characteristics of 2480 patients are summarized in Table 1. One hundred twenty-eight patients were diagnosed with gallstones. The incidence of gallstones at 5 and 10 years after gastrectomy was 11.4 and 19.1 percent, respectively (Figure 2). The interval between gastrectomy and diagnosis of gallstones was 45.9 months (range 1–149 months). Ninety-three of the 128 cases (72.7%) were diagnosed within 5 years after gastrectomy. The age of the 2352 patients (1554 men and 798 women) in the stone negative (SN) group was 59.9 ± 11.7 years and that of the 128 patients (80 men and 48 women) in the stone positive (SP) group was 60.6 ± 12.9 years. There were no significant differences in age (P = 0.539), gender (P = 0.407), BMI (P = 0.663), or diabetes mellitus (P = 0.095) between these two groups. With respect to types of gastrectomy, the proportion of total gastrectomy was higher in SP group than in SN group. Furthermore, the proportion of Roux-en-Y reconstruction and lymph node dissection in the hepatoduodenal ligament were higher in SP group than in SN group. Depth of invasion, lymph node metastasis, and TNM stage did not differ significantly between the two groups.


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)

Incidence of gallstones after gastrectomy.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig2: Incidence of gallstones after gastrectomy.
Mentions: The characteristics of 2480 patients are summarized in Table 1. One hundred twenty-eight patients were diagnosed with gallstones. The incidence of gallstones at 5 and 10 years after gastrectomy was 11.4 and 19.1 percent, respectively (Figure 2). The interval between gastrectomy and diagnosis of gallstones was 45.9 months (range 1–149 months). Ninety-three of the 128 cases (72.7%) were diagnosed within 5 years after gastrectomy. The age of the 2352 patients (1554 men and 798 women) in the stone negative (SN) group was 59.9 ± 11.7 years and that of the 128 patients (80 men and 48 women) in the stone positive (SP) group was 60.6 ± 12.9 years. There were no significant differences in age (P = 0.539), gender (P = 0.407), BMI (P = 0.663), or diabetes mellitus (P = 0.095) between these two groups. With respect to types of gastrectomy, the proportion of total gastrectomy was higher in SP group than in SN group. Furthermore, the proportion of Roux-en-Y reconstruction and lymph node dissection in the hepatoduodenal ligament were higher in SP group than in SN group. Depth of invasion, lymph node metastasis, and TNM stage did not differ significantly between the two groups.

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