Incidence of gallstones after gastric resection for gastric cancer: a nationwide claims-based study

Abstract

PurposeGallstone formation is one of the most common problems after gastrectomy. This retrospective cohort study used the South Korean nationwide claims database to evaluate the incidence and risk factors of gallstone after gastrectomy for gastric cancer.MethodsAll consecutive patients who underwent gastrectomy for gastric cancer in South Korea in 2008–2010 were identified. Incidence of gallstone formation 5 years after gastrectomy in males and females, in various age groups, and after different types of gastrectomy was determined. Multivariate logistic regression analysis served to identify gallstone risk factors.ResultsOf the 47,752 patients, 2,506 (5.2%) developed gallstone during the 5-year follow-up period. At 12, 24, 36, and 48 months, the cumulative incidences were 1.2%, 2.2%, 3.3%, and 4.3%, respectively. Males had a higher incidence than females (5.8% vs. 4.1%, P < 0.001). Older patients (60–89 years) had a higher incidence than younger patients (30–59 years) (6.1% vs. 4.3%, P < 0.001). Gallstone was most common after total gastrectomy (6.6%), followed by proximal gastrectomy (5.4%), distal gastrectomy (4.8%), and pylorus-preserving distal gastrectomy (4.0%) (P < 0.001). Multivariate analysis showed that male sex (odds ratio [OR], 1.39), an older age (OR, 1.44), and total gastrectomy (OR, 1.40 vs. distal gastrectomy) were significant independent risk factors for postgastrectomy gallstone.ConclusionThe cumulative incidence of gallstone 5 years after gastrectomy for gastric cancer was 5.2%. Male sex, an older age, and total gastrectomy were significant risk factors. More careful monitoring for gallstone may be necessary in patients with such risk factors.

The Effect Of Lymph Node Dissection On Gallstone Formation in Patients Undergoing Total Gastrectomy For Gastric Adenocarcinoma

“…The width of lymph node dissection has been reported as a risk factor for gallstone disease that develops after gastrectomy (3,7,12). In a study of 805 patients, Akatsu found that gallstone disease was statistically significantly higher in the D2 dissection group (7).…”

“…Gastric cancer is one of the most frequent cancers causing death worldwide; and gastrectomy constitutes the basis of surgical treatment (1). Gallstone formation after curative surgery is a common complication, and its prevalence is reported to be 15%-25% higher than the general population (2,3). It is thought that the dissection of the hepatic branch of the vagus, bypassing of the duodenum, and the changes in the release of cholecystokine cause the gallbladder stone formation after gastrectomy (4)(5)(6).…”

“…It is thought that the dissection of the hepatic branch of the vagus, bypassing of the duodenum, and the changes in the release of cholecystokine cause the gallbladder stone formation after gastrectomy (4)(5)(6). Some publications propose that the extension of the lymph node dissection, in addition to gastrectomy, suggests an increase in the incidence of gallbladder stones (3,7). Patients with asymptomatic gallbladder stones after gastrectomy may develop severe biliary complications over time requiring surgical treatment (8,9).…”

Preservation of hepatic branch of the vagus nerve reduces the risk of gallstone formation after gastrectomy

“…Cholelithiasis is known as one of the long-term complications of gastrectomy [8][9][10][11][12][13]. The incidence of gallbladder stones (GBS) after gastrectomy, as reported in many studies, ranges from 5.2 to 15.3% in Korea [9][10][11], 7.4% in China [12], and 13.6% in Japan [13].…”

Sonographic Incidence of Cholelithiasis in the Individual With Positive Famil History

“…Several additional possible risk factors for the growth of gallbladder stones are sedentary way of life, elderly age group and family history of gallstones 9 . Gallbladder stones development is a multifactorial procedure including a large number of metabolic pathways 18 . It is claimed that females are multiple times more prone to this disease than males.…”