title: Impaired gallbladder function in patients after total gastrectomy.
abstract: OBJECTIVE
  The incidence of gallstones and gallbladder sludge is higher in patients after total gastrectomy than in general population. Formation of gallstones after gastrectomy is multifactorial. Here, we investigate the changes in gallbladder and biliary tract functions by cholescintygraphy and monitored changes in cholecystokinin (CCK) release in long-term survivors after total gastrectomy for gastric carcinoma.
  
  
  METHODS
  Patients had undergone total gastrectomy for gastric carcinoma at least five years ago. The final study population consisted of 25 patients.
  
  
  RESULTS
  Eight patients had undergone cholecystectomy before or at the time of gastrectomy. Gallstone formation was observed in seven of the remaining 17 patients during follow-up (41%). Maximum uptake of radioactivity and gallbladder maximum uptake was significantly delayed in the gastrectomy group than in the control group. There was no significant difference in CCK levels after the overnight fasting and at 60 minutes after stimulation among patients with or without stones in situ compared with healthy volunteers, but 30 minutes after the energy-rich drink patients had higher CCK levels than the control group.
  
  
  CONCLUSIONS
  In gastrectomy patients, technetium isotope visualisation of the gallbladder and time for maximum activity was significantly delayed. This may indicate impaired gallbladder function. On the contrary, CCK release was not impaired.
authors.affiliation: a Department of Gastroenterology and Alimentary Tract Surgery , Tampere University Hospital , Tampere , Finland.
authors.forename: Tuula
authors.initials: T
authors.lastname: Tyrväinen
authors.affiliation: a Department of Gastroenterology and Alimentary Tract Surgery , Tampere University Hospital , Tampere , Finland.
authors.forename: Isto
authors.initials: I
authors.lastname: Nordback
authors.affiliation: b Department of Clinical Physiology , Tampere University Hospital , Tampere , Finland.
authors.forename: Jyri
authors.initials: J
authors.lastname: Toikka
authors.affiliation: c Department of Clinical Radiology , Tampere University Hospital , Tampere , Finland.
authors.forename: Anneli
authors.initials: A
authors.lastname: Piiroinen
authors.affiliation: d Institute of Biomedicine and Biocenter of Oulu, University of Oulu, Medical Research Center Oulu and Oulu University Hospital , Oulu , Finland.
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Herzig
authors.affiliation: d Institute of Biomedicine and Biocenter of Oulu, University of Oulu, Medical Research Center Oulu and Oulu University Hospital , Oulu , Finland.
authors.forename: Kari
authors.initials: K
authors.lastname: Mäkelä
authors.affiliation: a Department of Gastroenterology and Alimentary Tract Surgery , Tampere University Hospital , Tampere , Finland.
authors.forename: Juhani
authors.initials: J
authors.lastname: Sand
mesh_terms: D000368:Aged; D001659:Biliary Tract / Q000000981:diagnostic imaging*; D002277:Carcinoma / Q000601:surgery; D016022:Case-Control Studies; D002763:Cholecystectomy / Q000009:adverse effects*; D002766:Cholecystokinin / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D005704:Gallbladder / Q000503:physiopathology*; D042882:Gallstones / Q000000981:diagnostic imaging*; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011877:Radionuclide Imaging; D013274:Stomach Neoplasms / Q000601:surgery; D019785:Technetium Tc 99m Disofenin
chemical_list: D002766:Cholecystokinin; D019785:Technetium Tc 99m Disofenin
keywords: Total gastrectomy; cholecystokinin; cholescintygraphy; gallstones