J Gastric Cancer.  2019 Dec;19(4):417-426. 10.5230/jgc.2019.19.e37.

Risk Factors for Gallbladder Stone Formation after Gastric Cancer Surgery

• Lee YW
• Kim A
• Han M
• Yoo MW

• KMID: 2466030
• DOI: http://doi.org/10.5230/jgc.2019.19.e37

Abstract

PURPOSE
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.
MATERIALS AND METHODS
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.
RESULTS
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.
CONCLUSIONS
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.

Keyword

Cholecystolithiasis; Stomach neoplasms; Gastrectomy; Incidence; Risk factors

MeSH Terms

Bilirubin
Chemotherapy, Adjuvant
Cholecystolithiasis
Chungcheongnam-do
Gallbladder*
Gallstones
Gastrectomy
Humans
Incidence
Medical Records
Multivariate Analysis
Retrospective Studies
Risk Factors*
Stomach Neoplasms*
Weight Loss
Bilirubin

Figure

• 

  Fig. 1 Algorithm of enrolled patients and each outcome. The figure shows the algorithm of enrolled patients and each outcome including the exclusion criteria of the study. GB = gallbladder.

• 

  Fig. 2 Graph showing the incidence rate of GB stone formation after gastrectomy for gastric cancer. (A) Kaplan-Meier analysis of the cumulative incidence of GB stone formation after gastrectomy for gastric cancer. (B) Incidence of GB stone formation after gastrectomy in patients over and under 63 years old (P=0.003). (C) Incidence of GB stone formation after gastrectomy in patients who lost under or over 6.2 kg in the 6 months after the surgery (P=0.002). (D) Incidence of GB stone formation after gastrectomy in patients who did or did not undergo adjuvant chemotherapy and (P=0.002). (E) Incidence of GB stone formation after gastrectomy in patients with relatively higher (≥0.5 mg/dL) or lower serum total bilirubin levels (<0.5 mg/dL) (P=0.003). GB = gallbladder.

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