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Risk Factors for Gallbladder Stone Formation after Gastric Cancer Surgery

  • Lee, Young-Won (Division of Stomach Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Amy (Division of Stomach Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Han, Minkyu (Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Yoo, Moon-Won (Division of Stomach Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2019.07.09
  • Accepted : 2019.10.07
  • Published : 2019.12.31

Abstract

Purpose: Although an increased incidence of gallbladder (GB) stone formation after gastrectomy has been reported, its etiology remains uncertain. The goal of this study was to explore the incidence of gallstone formation after gastrectomy in gastric cancer patients and investigate the risk factors therein. Materials and Methods: Medical records of patients who underwent curative gastrectomy, performed by a single surgeon between August 2012 and December 2015 at the Asan Medical Center, were retrospectively reviewed. Baseline characteristics and surgical outcomes, including GB stone gallstone formation after gastrectomy, were analyzed. Results: Of 561 patients included in the study, 36 presented with GB stone formation after gastrectomy for gastric cancer. The incidence of gallstone formation was 6.4%. The mean interval between gallstone formation and gastrectomy was 21.9 months. In multivariate analyses, the incidence of gallstone formation increased in patients 63 years or older, with greater than 6.2 kg weight loss in the first 6 months after the procedure, a preoperative serum total bilirubin level greater than 0.5 mg/dL, and in patients who did not receive adjuvant chemotherapy. Conclusions: This study presented risk factors for GB stone formation after gastric cancer surgery, and special attention should be afforded to patients with such risk factors.

Keywords

References

  1. Ahn HS, Lee HJ, Yoo MW, Jeong SH, Park DJ, Kim HH, et al. Changes in clinicopathological features and survival after gastrectomy for gastric cancer over a 20-year period. Br J Surg 2011;98:255-260. https://doi.org/10.1002/bjs.7310
  2. Choi IJ. Gastric cancer screening and diagnosis. Korean J Gastroenterol 2009;54:67-76. https://doi.org/10.4166/kjg.2009.54.2.67
  3. Park CH, Song KY, Kim SN. Treatment results for gastric cancer surgery: 12 years' experience at a single institute in Korea. Eur J Surg Oncol 2008;34:36-41. https://doi.org/10.1016/j.ejso.2007.03.004
  4. Liang TJ, Liu SI, Chen YC, Chang PM, Huang WC, Chang HT, et al. Analysis of gallstone disease after gastric cancer surgery. Gastric Cancer 2017;20:895-903. https://doi.org/10.1007/s10120-017-0698-5
  5. Lai SL, Yang JC, Wu JM, Lai IR, Chen CN, Lin MT, et al. Combined cholecystectomy in gastric cancer surgery. Int J Surg 2013;11:305-308. https://doi.org/10.1016/j.ijsu.2013.02.006
  6. Hauters P, de Neve de Roden A, Pourbaix A, Aupaix F, Coumans P, Therasse G. Cholelithiasis: a serious complication after total gastrectomy. Br J Surg 1988;75:899-900. https://doi.org/10.1002/bjs.1800750923
  7. Pezzolla F, Lantone G, Guerra V, Misciagna G, Prete F, Giorgio I, et al. Influence of the method of digestive tract reconstruction on gallstone development after total gastrectomy for gastric cancer. Am J Surg 1993;166:6-10. https://doi.org/10.1016/S0002-9610(05)80573-2
  8. 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
  9. Paik KH, Lee JC, Kim HW, Kang J, Lee YS, Hwang JH, et al. Risk factors for gallstone formation in resected gastric cancer patients. Medicine (Baltimore) 2016;95:e3157. https://doi.org/10.1097/MD.0000000000003157
  10. Park DJ, Kim KH, Park YS, Ahn SH, Park J, Kim HH. Risk factors for gallstone formation after surgery for gastric cancer. J Gastric Cancer 2016;16:98-104. https://doi.org/10.5230/jgc.2016.16.2.98
  11. 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
  12. Wu CC, Chen CY, Wu TC, Iiu TJ, P'eng PK. Cholelithiasis and cholecystitis after gastrectomy for gastric carcinoma: a comparison of lymphadenectomy of varying extent. Hepatogastroenterology 1995.42:867-872.
  13. 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
  14. Kodama I, Yoshida C, Kofuji K, Ohta J, Aoyagi K, Takeda J. Gallstones and gallbladder disorder after gastrectomy for gastric cancer. Int Surg 1996;81:36-39.
  15. 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.
  16. 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
  17. Tompkins RK, Kraft AR, Zimmerman E, Lichtenstein JE, Zollinger RM. Clinical and biochemical evidence of increased gallstone formation after complete vagotomy. Surgery 1972;71:196-200.
  18. Wang DQ. Aging per se is an independent risk factor for cholesterol gallstone formation in gallstone susceptible mice. J Lipid Res 2002;43:1950-1959. https://doi.org/10.1194/jlr.M200078-JLR200
  19. Reshetnyak VI. Concept of the pathogenesis and treatment of cholelithiasis. World J Hepatol 2012;4:18-34. https://doi.org/10.4254/wjh.v4.i2.18
  20. Rehnberg O, Haglund U. Gallstone disease following antrectomy and gastroduodenostomy with or without vagotomy. Ann Surg 1985;201:315-318. https://doi.org/10.1097/00000658-198503000-00010
  21. 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
  22. Ura K, Sarna SK, Condon RE. Antral control of gallbladder cyclic motor activity in the fasting state. Gastroenterology 1992;102:295-302. https://doi.org/10.1016/0016-5085(92)91813-J
  23. Inoue K, Fuchigami A, Higashide S, Sumi S, Kogire M, Suzuki T, et al. Gallbladder sludge and stone formation in relation to contractile function after gastrectomy. A prospective study. Ann Surg 1992;215:19-26. https://doi.org/10.1097/00000658-199201000-00002
  24. Stinton LM, Shaffer EA. Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut Liver 2012;6:172-187. https://doi.org/10.5009/gnl.2012.6.2.172