Cholelithiasis following peptic ulcer surgery: A prospective controlled study

Abstract

An association between gastric surgery and gallstones has been suggested but conflicting conclusions are found in the literature. A prospective study of 118 patients with proved duodenal ulcer disease has been undertaken to determine the true incidence of gallbladder disease. Sixty-one patients undergoing surgery and 57 patients treated medically were matched for age, sex and weight. All patients had oral cholecystography at entry into the study and at 18 months and 109 were reviewed radiologically at 3 years. Three patients in the surgical group developed asymptomatic gallstones whereas none were detected in the medical group. This gives an incidence of gallstones of 4.9 per cent 3 years after gastric surgery. These findings are discussed.

Increased Risk of Gallstones following Curative Gastrectomy for Cancer

“…Although a few contrary opinions [22,35,36] exist, this study confirms the previous findings [3,[5][6][7]37] that the GB volume increases after vagotomy or gastrec tomy with [3,5] or without [6,7,37] an impaired GB motor function. The increased GB area we observed around 1 month after surgery persisted henceforth, whereas the impaired contractile response to caerulein returned to normality in 6 months or so.…”

“…Although no definite explanation for an increased tendency toward GS formation in postgastrectomy pa tients exists, the most prevailing theories involve the adverse effects of vagotomy which cause a GB motor dysfunction [3][4][5][6][7][8][9][10][11] and an alteration in bile composition or secretion [15][16][17][18][19][20][21][22], The literature gives a wide inci dence range of GSs (10-40%) occurring after vagotomy, with a higher incidence for truncal (11.9-21 %) than for selective vagotomy (2.4-6%) [8. 10], As all the methods of gastrectomy for cancer we have employed inadver tently interrupt both vagal trunks (and more peripheral connections) during the radical lymph node dissection, we did not expect a small incidence of GSs after the sur gery [1].…”

Effects of Proximal Duodenal Transection and Anastomosis on Interdigestive Sphincter of Oddi Cyclic Motility in Conscious Dogs

“…A significant increase in the frequency of gallstones after a variety of gastric operations including vagotomy and gastrectomy has long been documented [1][2][3][4]. The reason for the high incidence of gallstones following the gastric operations is not completely understood.…”

Review article: gall‐bladder motility after intestinal surgery

“…Some studies have demonstrated an increased risk of development of gallstones after ulcer surgery, while others have failed to demonstrate any risk. 5 Another important question that has not been addressed sufficiently, is whether an eventually increased risk of gallstone formation results in an increased risk of gallstone disease. However, there are no available data on this subject in the literature.…”