Journal of Gastric Cancer

  • 제16권2호
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  • Pages.98-104
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  • 2016
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  • 2093-582X(pISSN)
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  • 2093-5641(eISSN)
대한위암학회 (The Korean Gastric Cancer Association)
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Risk Factors for Gallstone Formation after Surgery for Gastric Cancer

  • Park, Dong Jin (Department of Surgery, Seoul National University Bundang Hospital) ;
  • Kim, Ki Hyun (Department of Surgery, Seoul National University Bundang Hospital) ;
  • Park, Young Suk (Department of Surgery, Seoul National University Bundang Hospital) ;
  • Ahn, Sang-Hoon (Department of Surgery, Seoul National University Bundang Hospital) ;
  • Park, Do Joong (Department of Surgery, Seoul National University Bundang Hospital) ;
  • Kim, Hyung-Ho (Department of Surgery, Seoul National University Bundang Hospital)
  • 투고 : 2016.02.03
  • 심사 : 2016.04.26
  • 발행 : 2016.06.30
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초록

Purpose: The incidence of gallstones after gastrectomy for gastric cancer is higher than in the general population. However, the causes and mechanisms of post-gastrectomy gallstones are unclear. The aim of this study was to evaluate the incidence of gallstone formation and the risk factors for their development after gastrectomy for gastric cancer. Materials and Methods: Of 1,744 gastric cancer patients who underwent gastrectomy at Seoul National University Bundang Hospital between January 2010 and December 2012, 1,284 were included in this study and retrospectively reviewed. Patients' age, sex, body mass index (BMI), tumor location, stage, type of gastrectomy, type of reconstruction, and extent of node dissection were evaluated. Results: The incidence of gallstones after gastrectomy for gastric cancer was significantly higher in men than in women (P=0.019). Exclusion of the duodenum during reconstruction was associated with a significantly higher incidence of gallstones (P=0.003). Overweight and obese patients with BMI ${\geq}23kg/m^2$ had significantly higher incidence of gallstones than those with a lower BMI (P=0.006). Multivariate analysis showed that obesity (hazard ratio, HR=1.614; 95% confidence interval, CI: 1.135~2.296; P=0.008), male sex (HR=1.515, 95% CI: 1.029~2.231, P=0.033), and exclusion of the duodenum (HR=1.648, 95% CI: 1.192~2.280, P=0.003) were significant, independent risk factors for gallstones after gastrectomy. Conclusions: The cumulative incidence of gallstones for 5 years after gastrectomy was 15.3%. Male sex, obesity, and exclusion of the duodenum were risk factors for gallstone formation after gastrectomy. Careful surveillance will be required for these patient groups after gastrectomy.

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참고문헌

  1. Hwang JY, Lee JH, Chi KC, Park SI. Clinical review of cholelithiasis after gastric resection in gastric cancer patients. J Korean Surg Soc 2004;67:198-203.
  2. Kobayashi T, Hisanaga M, Kanehiro H, Yamada Y, Ko S, Nakajima Y. Analysis of risk factors for the development of gallstones after gastrectomy. Br J Surg 2005;92:1399-1403. https://doi.org/10.1002/bjs.5117
  3. Fukagawa T, Katai H, Saka M, Morita S, Sano T, Sasako M. Gallstone formation after gastric cancer surgery. J Gastrointest Surg 2009;13:886-889. https://doi.org/10.1007/s11605-009-0832-8
  4. Chen XJ, Li N, Huang YD, Ren S, Liu F, Chen L, et al. Factors for postoperative gallstone occurrence in patients with gastric cancer: a meta-analysis. Asian Pac J Cancer Prev 2014;15:877-881. https://doi.org/10.7314/APJCP.2014.15.2.877
  5. Jun KH, Kim JH, Kim JJ, Chin HM, Park SM. Retrospective analysis on the gallstone disease after gastrectomy for gastric cancer. Gastroenterol Res Pract 2015;2015:827864.
  6. Inoue K, Fuchigami A, Hosotani R, Kogire M, Huang YS, Miyashita T, et al. Release of cholecystokinin and gallbladder contraction before and after gastrectomy. Ann Surg 1987;205:27-32.
  7. Hahm J, Park J, Cho Y, Eun C, Lee Y, Choi H, et al. Changes in gallbladder motility in gastrectomized patients. Korean J Intern Med 2000;15:19-24. https://doi.org/10.3904/kjim.2000.15.1.19
  8. Yi SQ, Ohta T, Tsuchida A, Terayama H, Naito M, Li J, et al. Surgical anatomy of innervation of the gallbladder in humans and Suncus murinus with special reference to morphological understanding of gallstone formation after gastrectomy. World J Gastroenterol 2007;13:2066-2071. https://doi.org/10.3748/wjg.v13.i14.2066
  9. Chang YR, Jang JY, Kwon W, Park JW, Kang MJ, Ryu JK, et al. Changes in demographic features of gallstone disease: 30 years of surgically treated patients. Gut Liver 2013;7:719-724. https://doi.org/10.5009/gnl.2013.7.6.719
  10. Nakamura K, Ogoshi K, Makuuchi H. Clinicopathological study of cholelithiasis following gastric cancer surgery. Eur Surg Res 2005;37:29-35. https://doi.org/10.1159/000083145
  11. Akatsu T, Yoshida M, Kubota T, Shimazu M, Ueda M, Otani Y, et al. Gallstone disease after extended (D2) lymph node dissection for gastric cancer. World J Surg 2005;29:182-186. https://doi.org/10.1007/s00268-004-7482-5
  12. Sugita H, Kojima K, Inokuchi M, Kato K. Long-term outcomes of laparoscopic gastrectomy for gastric cancer. J Surg Res 2015;193:190-195. https://doi.org/10.1016/j.jss.2014.07.040
  13. Unisa S, Jagannath P, Dhir V, Khandelwal C, Sarangi L, Roy TK. Population-based study to estimate prevalence and determine risk factors of gallbladder diseases in the rural Gangetic basin of North India. HPB (Oxford) 2011;13:117-125. https://doi.org/10.1111/j.1477-2574.2010.00255.x
  14. Stender S, Nordestgaard BG, Tybjaerg-Hansen A. Elevated body mass index as a causal risk factor for symptomatic gallstone disease: a Mendelian randomization study. Hepatology 2013;58:2133-2141. https://doi.org/10.1002/hep.26563
  15. Radmard AR, Merat S, Kooraki S, Ashraf M, Keshtkar A, Sharafkhah M, et al. Gallstone disease and obesity: a population-based study on abdominal fat distribution and gender differences. Ann Hepatol 2015;14:702-709.
  16. Aune D, Norat T, Vatten LJ. Body mass index, abdominal fatness and the risk of gallbladder disease. Eur J Epidemiol 2015;30:1009-1019. https://doi.org/10.1007/s10654-015-0081-y
  17. Tsai CJ, Leitzmann MF, Willett WC, Giovannucci EL. Weight cycling and risk of gallstone disease in men. Arch Intern Med 2006;166:2369-2374. https://doi.org/10.1001/archinte.166.21.2369
  18. Nomura H, Kashiwagi S, Hayashi J, Kajiyama W, Ikematsu H, Noguchi A, et al. Prevalence of gallstone disease in a general population of Okinawa, Japan. Am J Epidemiol 1988;128:598-605. https://doi.org/10.1093/oxfordjournals.aje.a115007
  19. Heaton KW, Braddon FE, Mountford RA, Hughes AO, Emmett PM. Symptomatic and silent gall stones in the community. Gut 1991;32:316-320. https://doi.org/10.1136/gut.32.3.316
  20. Sun H, Tang H, Jiang S, Zeng L, Chen EQ, Zhou TY, et al. Gender and metabolic differences of gallstone diseases. World J Gastroenterol 2009;15:1886-1891. https://doi.org/10.3748/wjg.15.1886
  21. Ando S, Tsuji H. Surgical technique of vagus nerve-preserving gastrectomy with D2 lymphadenectomy for gastric cancer. ANZ J Surg 2008;78:172-176. https://doi.org/10.1111/j.1445-2197.2007.04396.x
  22. Inokuchi M, Sugita H, Otsuki S, Sato Y, Nakagawa M, Kojima K. Long-term effectiveness of preserved celiac branch of vagal nerve after Roux-en-Y reconstruction in laparoscopy-assisted distal gastrectomy. Dig Surg 2014;31:341-346. https://doi.org/10.1159/000368703

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  3. Increased risk of gallstones after gastrectomy : A longitudinal follow-up study using a national sample cohort in korea vol.98, pp.22, 2016, https://doi.org/10.1097/md.0000000000015932
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  5. Laparoscopic treatment of a recurrent biliary stone forming around a Hem-o-lok clip in a patient with previous gastrectomies : Case report vol.100, pp.38, 2016, https://doi.org/10.1097/md.0000000000027213
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