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 23 February 2018

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News

Gallstone risk factors after gastrectomy

The most recent issue of the British Journal of Surgery finds that lymph node dissection in the hepatoduodenal ligament, total gastrectomy and exclusion of the duodenum are risk factors for gallstones after gastrectomy.

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The incidence of gallstones is higher in people who have undergone gastrectomy than in the general population, but the cause of this is unknown.

Dr Kobayashi and colleagues carried out ultrasonography of the gallbladder after gastrectomy for gastric cancer in 749 patients.

A total of 2327 examinations were carried out between 1992 and 2003.

The incidence of gallstones was compared in subgroups of patients.

The patients were classified according to the extent of gastrectomy, whether the duodenum was excluded and type of lymph node dissection or reconstruction.

At 5 years, gallstones incidence was 28% after total vs 8% after partial gastrectomy
British Journal of Surgery

The researchers found that the incidence of gallstones was significantly higher after total compared with partial gastrectomy, at 28% vs 8% at 5 years.

Reconstruction with duodenal exclusion was associated with a significantly higher incidence than non-exclusion, at 25% vs 8% at 5 years.

The researchers noted that those with lymph node dissection in the hepatoduodenal ligament had a higher incidence of gallstones than those who did not.

The research team undertook multivariate analysis that included type of reconstruction and lymph node dissection.

The team observed that lymph node dissection in the hepatoduodenal ligament was identified as the most significant risk factor for gallstone development.

Dr Kobayashi's team concludes, “Lymph node dissection in the hepatoduodenal ligament, total gastrectomy and exclusion of the duodenum are risk factors for gallstones after gastrectomy.”

Br J Surg 2005: 92(11): 1399-1403
27 October 2005

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