THE INCIDENCE AND FACTOR OF GALLSTONE FORMATION AFTER GASTRECTOMY

Abstract

To evaluate the incidence and period of gallstone formation after gastrectomy for a carcinoma, questionnaire survey has been conducted in 316 patients. Replies were obtained through 81% of the patients. Except for 48 unknown cases, 31 (15%) out of the 209 patients had gallstones. Additionally, 5 patients had gallbladder debris, 3 had cholesterol polyp, and one had acute cholecystitis. Overall 40 patients (19%) had some gallbladder disease. In 50 patients undergoing total gastrectomy, 13 (26%) had gallstones, and 17 (34%) had some gallbladder diseases. Gallstone was found within 5 years after gastrectomy in 14 cases, between 5 to 10 years in 12 cases, and after 10 years in 5 cases. In 26 cases (84%), gallstone was found within 10 years. Cholecystectomy was done in 13 patients, but 18 patients had no symptom and have been periodically checked at the outpatient clinic. In 13 cholecystectomised patients, 9 had black stone, and 2 had bilirubin stone. In the remaining 2 cases, nature of the stone was unclear. There was no cholesterol stone. In follow up of postgastrectomy patients with gastric cancer, special attention should be given to gallstone formation as well as recurrence. In such situation, the adequacy of prophylactic cholecystectomy would be a further problem to be solved.