[Acute noncalculous cholecystitis following gastrectomy for gastric cancer--study by ultrasonic examination].

In 190 patients who were operated for gastric cancer, incidence of post-operative noncalculous acute cholecystitis was studied. Twenty four patients was diagnosed as postoperative acute cholecystitis mainly by ultrasonic examination. As the sonographic appearance of 24 diagnosed cases, gallbladder distention was observed in 6 cases (25%), a thickened gallbladder wall in 19 cases (79%), intraluminal echoes within the gallbladder in 20 cases (83%) and sonolucent layer around the gallbladder in 14 cases (58%). In many cases clinical symptoms were so mild that without ultrasound they might be dealt with fever of unknown origin. With regard to treatment, conservative therapy by antibiotics was performed in 18 cases and ultrasonically guided percutaneous transhepatic gallbladder drainage in 6 cases. In many cases, sludge demonstrated during the initial stage of acute cholecystitis remained for long period. In 6 cases, intraluminal echoes gradually changed into gallstones. Frequency of postoperative acute cholecystitis was 12.6% (24/190)--Subtotal gastrectomy: 8.4% (11/131), total gastrectomy: 23.0% (11/48) and proximal gastrectomy: 18.2% (2/11). In cases of Appleby operation, incidence was especially high--27.0% (10/37). Acute cholecystitis after gastrectomy for gastric cancer is not so rate complication as considered previously.