Analysis Of Related Factors Of Gallbladder Stones After Radical Gastrectomy

Objective A large number of clinical studies have found that the incidence of postoperative gallbladder stones in patients with gastric cancer was higher than normal people,its still inconclusive about the high risk factors and prophylactic cholecystectomy in gastric cancer surgery.To clarify the risk factors of postoperative gallbladder stones with gastric cancer,and discuss the necessity of prophylactic cholecystectomy,in order to provide some reference value for clinical work.Methods All the inpatients with gastric cancer diagnosed by pathology after radical gastrectomy were included in the General Hospital of Ningxia Medical University from January 2009 to December 2013.The clinical dates were collected and reviewed.Results 163 patients with radical gastrectomy were followed up for a long time in this study,the incidence of gallbladder stones was 16.5%(27/163)within 5 years,of which70.3%(19/27)occurred within 3 years after surgery.Among the 27 patients,21(77.7%)had no obvious symptoms,2 had biliary pancreatitis,all of which were relieved after conservative treatment,and 4 had cholecystectomy due to acute calculous cholecystitis.In patients with gallbladder stones,there were 14 patients with the diameter of the stone less than 10 mm,of which 2 patients were accompanied with cholelithiasis and 13 cases were10mm~30mm in diameter.The range of gastrectomy(P=0.066),lymph node dissection in the12 th group(P=0.087),tumor stage(P=0.33),degree of differentiation(P=0.067)and the occurrence of gallbladder stones were not statistically significant,but the incidence ofpostoperative gallbladder stones in patients with non-physiological reconstruction of digestive tract was higher than that in patients with physiological reconstruction(P=0.006).The incidence of postoperative biochemical indicator such as blood glucose,cholesterol,total bilirubin,direct bilirubin,glutamyl transferase(GGT),alkaline phosphatase(ALP)and gallstones in patients with gastric cancer were also not statistically significant.Conclusion The incidence of gallbladder stones in patients with gastric cancer was16.5% within 5 years after operation,and of which 70.3% occurred in the three years,the majority of patients with gallbladder stones had no obvious symptoms.Therefore,prophylactic cholecystectomy was not recommended in patients with gastric cancer.Follow-up should be carried out regularly after operation,especially in patients with gastric cancer with high risk factors,such as non-physiological reconstruction of digestive tract.