J Gastric Cancer.  2016 Jun;16(2):98-104. 10.5230/jgc.2016.16.2.98.

Risk Factors for Gallstone Formation after Surgery for Gastric Cancer

• Park DJ
• Kim KH
• Park YS
• Ahn SH
• Park DJ
• Kim HH

• KMID: 2328076
• DOI: http://doi.org/10.5230/jgc.2016.16.2.98

Abstract

PURPOSE
The incidence of gallstones after gastrectomy for gastric cancer is higher than in the general population. However, the causes and mechanisms of post-gastrectomy gallstones are unclear. The aim of this study was to evaluate the incidence of gallstone formation and the risk factors for their development after gastrectomy for gastric cancer.
MATERIALS AND METHODS
Of 1,744 gastric cancer patients who underwent gastrectomy at Seoul National University Bundang Hospital between January 2010 and December 2012, 1,284 were included in this study and retrospectively reviewed. Patients' age, sex, body mass index (BMI), tumor location, stage, type of gastrectomy, type of reconstruction, and extent of node dissection were evaluated.
RESULTS
The incidence of gallstones after gastrectomy for gastric cancer was significantly higher in men than in women (P=0.019). Exclusion of the duodenum during reconstruction was associated with a significantly higher incidence of gallstones (P=0.003). Overweight and obese patients with BMI ≥23 kg/m2 had significantly higher incidence of gallstones than those with a lower BMI (P=0.006). Multivariate analysis showed that obesity (hazard ratio, HR=1.614; 95% confidence interval, CI: 1.135~2.296; P=0.008), male sex (HR=1.515, 95% CI: 1.029~2.231, P=0.033), and exclusion of the duodenum (HR=1.648, 95% CI: 1.192~2.280, P=0.003) were significant, independent risk factors for gallstones after gastrectomy.
CONCLUSIONS
The cumulative incidence of gallstones for 5 years after gastrectomy was 15.3%. Male sex, obesity, and exclusion of the duodenum were risk factors for gallstone formation after gastrectomy. Careful surveillance will be required for these patient groups after gastrectomy.

Keyword

Gallstones; Stomach neoplasms; Gastrectomy; Incidence; Risk factors

MeSH Terms

Body Mass Index
Duodenum
Female
Gallstones*
Gastrectomy
Humans
Incidence
Male
Multivariate Analysis
Obesity
Overweight
Retrospective Studies
Risk Factors*
Seoul
Stomach Neoplasms*

Figure

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  Fig. 1 Flow chart showing patient characteristics following gastrectomy.

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  Fig. 2 (A) Cumulative incidence of gallstones after gastrectomy. (B) Incidence of post-gastrectomy gallstones in men and women (P<0.01, log rank test). (C) Incidence of gallstones after gastrectomy in patients who underwent reconstruction with or without duodenal exclusion (P<0.01, log rank test). (D) Incidence of post-gastrectomy gallstones in overweight and obese patients (≥23 kg/m2) vs. normal and underweight (<23 kg/m2) patients (P<0.001, log rank test). BMI = body mass index.

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