title: Treatment of biliary tract stones after gastrectomy in the era of laparoscopic cholecystectomy.
abstract: BACKGROUND
  The incidence of biliary tract stones has widely been reported to be high after gastrectomy. Treatment of biliary tract stones in post-gastrectomy patients was examined retrospectively, particularly minimally invasive therapy with laparoscopic cholecystectomy for gallbladder stones and endoscopic bile duct lithotomy for common bile duct stones.
  
  
  METHODS
  Treatment of 122 post-gastrectomy patients with biliary tract stones was examined retrospectively from 1995 to April 2015.
  
  
  RESULTS
  Symptomatic biliary tract stones were found in 3.7% of post-gastrectomy patients. The frequency of bile duct stones was higher in post-gastrectomy patients with gallbladder stones (44%) than in the nongastrectomy patients (11%). Laparoscopic cholecystectomy was carried out in 84% of the patients with gallbladder stones. Endoscopic bile duct lithotomy was feasible in 89% of patients with common bile duct stones.
  
  
  CONCLUSIONS
  Laparoscopic cholecystectomy was feasible for removing gallbladder stones after gastrectomy. Endoscopic bile duct lithotomy followed by laparoscopic cholecystectomy was a good option for patients in whom endoscopic intervention could be performed. On the other hand, choledochoenterostomy could be a good option for patients in whom endoscopic bile duct lithotomy cannot be performed, particularly considering the risk of recurrent bile duct stones.
authors.affiliation: Department of Digestive Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo 105-8470, Japan.
authors.forename: Masaji
authors.initials: M
authors.lastname: Hashimoto
authors.affiliation: Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.
authors.forename: Tsunao
authors.initials: T
authors.lastname: Imamura
authors.affiliation: Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Tamura
authors.affiliation: Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.
authors.forename: Rikako
authors.initials: R
authors.lastname: Koyama
authors.affiliation: Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Koizumi
authors.affiliation: Sannoudai Hospital, Ibaragi, Japan.
authors.forename: Mikio
authors.initials: M
authors.lastname: Makuuchi
authors.affiliation: Department of Digestive Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo 105-8470, Japan.
authors.forename: Masamichi
authors.initials: M
authors.lastname: Matsuda
authors.affiliation: Department of Digestive Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo 105-8470, Japan.
authors.forename: Goro
authors.initials: G
authors.lastname: Watanabe
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D002768:Choledochostomy / Q000379:methods; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery*; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D015994:Incidence; D007564:Japan; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D016896:Treatment Outcome
keywords: Bile duct stone; Endoscopic bile duct lithotomy; Gallbladder stone; Gastrectomy; Laparoscopic cholecystectomy