Gallstone formation after gastric cancer surgery.
BACKGROUND
Gallstone formation is one of the most common complications after gastric cancer surgery, but the mechanism and etiology for such formation are unclear because of a lack of collective clinical investigation.


METHODS
We evaluated the influence of various surgical factors on the incidence of gallstone formation after gastrectomy. Gallstone formation was confirmed by ultrasound examinations that were routinely carried out after surgery on a periodic basis.


RESULTS
Gallstone formation occurred in 173 of 672 (25.7%) patients who had undergone gastrectomy with lymph-node dissection for gastric cancer. The types of gastrectomy and reconstruction had no significant effect on the incidence, but the extent of lymph-node dissection was a significant factor (p < 0.001: D1 + alpha vs. D2 + alpha; p < 0.01: D2 vs. D2 + alpha). Gallstones were usually formed within 2 years after gastrectomy, but in most cases, gallstone formation was asymptomatic.


CONCLUSIONS
The extent of lymph-node dissection was a significant factor in gallstone formation after gastrectomy; therefore, prophylactic cholecystectomy should be considered in cases of extensive lymph-node dissection.
Fukagawa
Takeo
T
Gastric Surgery Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. tfukagaw@ncc.go.jp
Katai
Hitoshi
H
Saka
Makoto
M
Morita
Shinji
S
Sano
Takeshi
T
Sasako
Mitsuru
M
D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D002763:Cholecystectomy; D015331:Cohort Studies; D042882:Gallstones / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy; D005743:Gastrectomy / Q000009:adverse effects*; D005763:Gastroenterostomy / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D014463:Ultrasonography