Gallstone formation after gastric cancer surgery

Abstract

Background: Gallstone formation is one of the most common complications after gastric cancer surgery, but the mechanism and etiology for such formation are unclear because of a lack of collective clinical investigation.

Method: We evaluated the influence of various surgical factors on the incidence of gallstone formation after gastrectomy. Gallstone formation was confirmed by ultrasound examinations that were routinely carried out after surgery on a periodic basis.

Results: Gallstone formation occurred in 173 of 672 (25.7%) patients who had undergone gastrectomy with lymph-node dissection for gastric cancer. The types of gastrectomy and reconstruction had no significant effect on the incidence, but the extent of lymph-node dissection was a significant factor (p < 0.001: D1 + alpha vs. D2 + alpha; p < 0.01: D2 vs. D2 + alpha). Gallstones were usually formed within 2 years after gastrectomy, but in most cases, gallstone formation was asymptomatic.

Conclusion: The extent of lymph-node dissection was a significant factor in gallstone formation after gastrectomy; therefore, prophylactic cholecystectomy should be considered in cases of extensive lymph-node dissection.