Lee Young-Won, Kim Amy, Han Minkyu, Yoo Moon-Won
Division of Stomach Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
J Gastric Cancer. 2019 Dec;19(4):417-426. doi: 10.5230/jgc.2019.19.e37. Epub 2019 Nov 6.
Although an increased incidence of gallbladder (GB) stone formation after gastrectomy has been reported, its etiology remains uncertain. The goal of this study was to explore the incidence of gallstone formation after gastrectomy in gastric cancer patients and investigate the risk factors therein.
Medical records of patients who underwent curative gastrectomy, performed by a single surgeon between August 2012 and December 2015 at the Asan Medical Center, were retrospectively reviewed. Baseline characteristics and surgical outcomes, including GB stone gallstone formation after gastrectomy, were analyzed.
Of 561 patients included in the study, 36 presented with GB stone formation after gastrectomy for gastric cancer. The incidence of gallstone formation was 6.4%. The mean interval between gallstone formation and gastrectomy was 21.9 months. In multivariate analyses, the incidence of gallstone formation increased in patients 63 years or older, with greater than 6.2 kg weight loss in the first 6 months after the procedure, a preoperative serum total bilirubin level greater than 0.5 mg/dL, and in patients who did not receive adjuvant chemotherapy.
This study presented risk factors for GB stone formation after gastric cancer surgery, and special attention should be afforded to patients with such risk factors.
虽然已有报道称胃切除术后胆囊结石形成的发生率增加,但其病因仍不明确。本研究的目的是探讨胃癌患者胃切除术后胆结石形成的发生率,并调查其中的危险因素。
回顾性分析2012年8月至2015年12月在峨山医学中心由一名外科医生进行根治性胃切除术的患者的病历。分析了包括胃切除术后胆囊结石形成在内的基线特征和手术结果。
在纳入研究的561例患者中,36例在胃癌胃切除术后出现胆囊结石形成。胆结石形成的发生率为6.4%。胆结石形成与胃切除术之间的平均间隔时间为21.9个月。在多因素分析中,63岁及以上患者、术后前6个月体重减轻超过6.2 kg、术前血清总胆红素水平大于0.5 mg/dL以及未接受辅助化疗的患者胆结石形成的发生率增加。
本研究提出了胃癌手术后胆囊结石形成的危险因素,对于有这些危险因素的患者应给予特别关注。