Pezzolla F, Lantone G, Guerra V, Misciagna G, Prete F, Giorgio I, Lorusso D
Department of Surgery and Laboratory of Epidemiology, Scientific Institute for Digestive Diseases, S. De Bellis, Castellana Grotte, (Bari), Italy.
Am J Surg. 1993 Jul;166(1):6-10. doi: 10.1016/s0002-9610(05)80573-2.
The aim of this study was to evaluate whether total gastrectomy performed for gastric cancer leads to an increased risk of cholelithiasis and whether the method of reconstruction of the digestive tract influences that risk. A total of 102 patients who had undergone total gastrectomy for gastric cancer between 1980 and 1990 were studied. The preoperative prevalence of cholelithiasis was 4% in men and 12% in women. Eighty-seven patients (85%) without gallstones before surgery were reexamined after gastrectomy. The postoperative prevalence of cholelithiasis in this group was 36% in men and 19% in women. Before surgery, the difference between the expected frequency of cholelithiasis (calculated on the basis of the data of a community survey) and the observed frequency was not statistically significant (p > 0.05) either in men or women. After surgery, the observed frequency of gallstones was significantly higher than the expected frequency in men (p < 0.0001) but not in women (p = 0.06). The risk of cholelithiasis was significantly higher in patients with Roux-en-Y reconstruction (n = 55) than in those with jejunal interposition (n = 32) (log-rank test, p = 0.03), and that risk was independent of age, sex, and body mass index.
本研究的目的是评估因胃癌行全胃切除术是否会增加患胆结石的风险，以及消化道重建方法是否会影响该风险。对1980年至1990年间因胃癌接受全胃切除术的102例患者进行了研究。术前胆结石的患病率男性为4%，女性为12%。87例术前无胆结石的患者（85%）在胃切除术后接受了复查。该组术后胆结石的患病率男性为36%，女性为19%。术前，胆结石的预期发生率（根据社区调查数据计算）与观察到的发生率之间的差异在男性和女性中均无统计学意义（p>0.05）。术后，男性胆结石的观察发生率显著高于预期发生率（p<0.0001），但女性则不然（p = 0.06）。采用Roux-en-Y重建术的患者（n = 55）患胆结石的风险显著高于采用空肠间置术的患者（n = 32）（对数秩检验，p = 0.03），且该风险与年龄、性别和体重指数无关。
