Related factors of postoperative gallstone formation after distal gastrectomy: A meta-analysis

Chen, Y; Li, Yong

doi:10.4103/ijc.ijc_91_17

Cited by 12 publications

(3 citation statements)

References 21 publications

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“…It is widely accepted that patients with a history of gastrectomy have an increased incidence of CCL and increased morbidities requiring surgery [ 9 ]. The exact mechanisms for these observations remain unclear.…”

Section: Discussionmentioning

confidence: 99%

Clinical analysis of treatment strategies to cholecystocholedocholithiasis patients with previous subtotal or total gastrectomy: a retrospective cohort study

Zhang

Sun

et al. 2018

BMC Surg

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BackgroundPrevious gastrectomy can lead to an increased incidence of cholecystocholedocholithiasis (CCL) and increased morbidity rate. However, the appropriate treatment strategy for patients with CCL and a history of gastrectomy remains unclear.MethodsWe performed a retrospective cohort study of patients with CCL and a history of gastrectomy who underwent either one-stage laparoscopic common bile duct (CBD) exploration with stone clearance and laparoscopic cholecystectomy (LCBDE+LC) or two-stage endoscopic retrograde cholangiopancreatography followed by LC (ERCP+LC) from May 2010 to March 2018.ResultsThe success rate of ERCP for CBD stone clearance was 81.2% in patients with a history of Billroth I gastrectomy and 23.7% in patients with a history of Billroth II or Roux-en-Y esophagojejunostomy [χ2 = 97.67, P < 0.001, risk ratio (RR) = 3.43]. The success rate of second-step LC after successful ERCP for removal of CBD stones and the success rate of LCBDE+LC after ERCP treatment failure were 96.8 and 87.7%, respectively, in patients with preoperative intra-abdominal adhesion evaluation scores of ≤3 points. These success rates were 28.6 and 27.6%, respectively, in patients with scores of > 3 points (χ2 = 59.70, P < 0.001, RR = 3.38 and χ2 = 53.41, P < 0.001, RR = 3.27, respectively).ConclusionsBased on the results of this study, ERCP+LC seems to be an attractive strategy for treatment of CCL in patients with a history of Billroth I gastrectomy, and LCBDE+LC appears to be suitable for patients with a history of Billroth II or Roux-en-Y esophagojejunostomy. Preoperative evaluation of intra-abdominal adhesions helps to reduce the conversion rate of laparoscopic surgery.

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Section: Discussionmentioning

confidence: 99%

Clinical analysis of treatment strategies to cholecystocholedocholithiasis patients with previous subtotal or total gastrectomy: a retrospective cohort study

Zhang

Sun

et al. 2018

BMC Surg

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“…It is generally accepted that performance of gastrectomy in gastric cancer patients can lead to an increased incidence of cholecystolithiasis (CL) and a higher rate of morbidities that require secondary surgery [1], which may related with the complex interaction between sectioning of the nerve supply to the gallbladder and the change in cholecystokinin secretion [2, 3]. However, performance of routine prophylactic cholecystectomy during radical gastrectomy is still being debated [4].…”

Section: Introductionmentioning

confidence: 99%

Clinical analysis of prophylactic cholecystectomy during gastrectomy for gastric cancer patients: a retrospective study of 1753 patients

et al. 2019

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Background Performance of gastrectomy in gastric cancer patients can lead to an increased incidence of cholecystolithiasis (CL) and a higher morbidity rate. However, the value of prophylactic cholecystectomy performed during gastric cancer surgery is still being debated. Methods We carried out a retrospective study on patients with gastric cancer who underwent subtotal or total gastrectomy, with preservation of the gallbladder or simultaneous cholecystectomy from January 2010 to March 2018. Results Cholecystolithiasis occurred in 152 of 1691 (8.98%) patients after gastric cancer surgery, with 45 (2.67%) patients undergoing subsequent cholecystectomy. Postoperative body mass index (BMI) decrease > 5% in 3 months was an independent risk factor for cholecystolithiasis [BMI decrease > 5%/≤5%: OR (95%CI): 1.812 (1.225–2.681), p = 0.003). Gastrectomy method and diabetes mellitus were independent risk factors for both cholecystolithiasis [gastrectomy method (no-Billroth I/Billroth I): OR (95%CI): 1.801 (1.097–2.959), p = 0.002; diabetes mellitus (yes/no): OR (95%CI): 1.544 (1.030–2.316), p = 0.036] and subsequent cholecystectomy [gastrectomy method (no-Billroth I/Billroth I): OR (95%CI): 5.432 (1.309–22.539), p = 0.020; diabetes mellitus (yes/no): OR (95%CI): 2.136 (1.106–4.125), p = 0.024]. Simultaneous cholecystectomy was performed in 62 of 1753 (3.5%) patients. The mortality and morbidity rates did not differ significantly between the combined surgery group and the gastrectomy only group (8.1% vs. 8.9 and 1.6% vs. 2.2%, respectively, p > 0.05). Conclusions Prophylactic cholecystectomy may be necessary in gastric cancer patients without Billroth I gastrectomy and with diabetes mellitus. Simultaneous cholecystectomy during gastric cancer surgery does not increase the postoperative mortality and morbidity rates.

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“…The risk of gallstone formation after gastrectomy has been reported in many studies . [1,2] Causes include resection of the hepatic branch of the vagus nerve , [3] nonphysiologic reconstruction, [4] infection of the biliary tract, [5] and altered response and secretion of cholecystokinin. [6,7]…”

Section: Introductionmentioning

confidence: 99%

Increased risk of gallstones after gastrectomy

et al. 2019

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Related factors of postoperative gallstone formation after distal gastrectomy: A meta-analysis

Abstract: Our analysis indicated that digestive tract reconstruction and vagus nerve resection were strongly and consistently associated with gallstone formation after DG.

Cited by 12 publications

References 21 publications

Clinical analysis of treatment strategies to cholecystocholedocholithiasis patients with previous subtotal or total gastrectomy: a retrospective cohort study

Clinical analysis of treatment strategies to cholecystocholedocholithiasis patients with previous subtotal or total gastrectomy: a retrospective cohort study

Clinical analysis of prophylactic cholecystectomy during gastrectomy for gastric cancer patients: a retrospective study of 1753 patients

Increased risk of gallstones after gastrectomy

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