Clinical Review of Cholelithiasis after Gastric Resection in Patients with Stomach Cancer

Song, Chang Ho; Park, Ho Chul; Youn, Choong; Joo, Hoong Zae

Abstract

This is a review of gastric resection surgeries that were carried out in 570 patients with stomach cancer who were admitted to Kyung Hee University Hospital from January, 1989 through December, 1993. In order to establish the incidence of cholelithiasis after gastric resection, patients was examined with abdominal ultrasonography preoperatively and postoperatively. The prevalence of cholelithiasis at admission was 4.6%. Study candidates consisted of 366 patients, except those who had cholelithiasis preoperatively and who didn't have a follow-up after gastric resection. Cholelithiasis after gastric resection developed in 16.4%(60/366) of patients, and which was significantly higher than incidence of cholelithiasis at admission(p<0.05). The incidence of cholelithiasis was not related significantly to the sex or age of the patients(p>0.05). In 51.6%(31/60) of patients, cholelithiasis have developed within 1 year after operation. The incidence of cholelithiasis after total gastrectomy with esophagojejunostomy(21.8%) was higher than subtotal gastrectomy with gastrojejunostomy(15.3%) or with gastroduodenostomy(14.3%), but it was not shown to be a statistical difference(p>0.05). There was no relation between the incidence of cholelithiasis and the stage of the stomach cancer. Four of the sixty patients presenting cholelithiasis underwent cholesystectomy because of significant billiary symptoms. In conclusion, cholelithiasis appears to be a frequent complication after gastrectomy. It may be related to the vagotomy which is performed at the time of gastric resection.