Preliminary Analysis Of Risk Factors For Gallbladder Stones After Radical Gastric Cancer

Objectives:More and more clinical researchs have found that the incidence of gallbladder stones in patients with gastric cancer is higher than that in the normal people.However,which high-risk factors lead to an increased incidence of postoperative gallbladder stones and whether cholecystectomy is performed during the radical operation of gastric cancer is still inconclusive.This study retrospectively analyzed the general rules and possible risk factors of gallbladder stones after radical gastric cancer,to understand the influencing factors of gallbladder stones after radical gastric cancer surgery better.And discuss the pros and cons of concurrent cholecystectomy to provide a basis for its prevention and treatment,provide a certain reference value for clinicians,and further improve the quality of life of patients with gastric cancer after surgery.Subjects and methods:Collecting clinical data of 518 patients who underwent radical gastrectomy for gastric cancer during the period from January 2012 to March 2017 in the Department of Gastrointestinal Surgery,Northern Jiangsu Province Hospital.To retrospectively analysis of the perioperative situation of patients,and to understand the status of the gallbladder with multiple auxiliary examinations before and after operation.To evaluate the incidence of gallstone after radical gastrectomy,Patient parameters including gender,age,body mass index(BMI),TNM stage,hypertension,diabetes,fasting blood glucose,hyperlipidemia,helicobacter pylori(HP)infection,family history,surgical approach,scope of surgical resection etc.And discuss the pros and cons of concurrent cholecystectomyResults:(1).Whether the gallbladder has a disease before surgery has no significant effect on the occurrence of gallbladder stones after surgery(2).The incidence of gallbladder stones after radical gastric cancer was 14.48%,occurring within 3-6 months after surgery.and the number and incidence of gallbladder stones have gradually decreased and stabilized 6 months after surgery.72%(54/75)of patients with postoperative gallbladder stones had no significant discomfort and only 28%(21/75)of patients had non-specific upper abdominal symptoms.Nobody showed typical symptoms of biliary colic.Symptoms relieved in 17 patients with non-surgical treatment.Only 4 patients underwent LC,And there are no serious complications after surgery.(3).Patient's age(P=0.012),body mass index(BMI)(P=0.038),fasting blood glucose(FPG?6.1mmol/1)(P=0.016),hyperlipidemia(P=0.004),and surgical resection range(P=0.034)are closely related to the occurrence of postoperative gallbladder stones.Age? 65,BMI>23 kg/m2,FPG>6.1mml/l,hyperlipidemia,and total gastrectomy are risk factors for gallbladder stones after radical gastric cancer(P<0.05).However the Patients' gender,tumor TNM stage,diabetes,hypertension,helicobacter pylori(HP)infection,family history,surgical methods,and whether food passed through the duodenum had no statistically significant difference in postoperative gallbladder stones(P>0.05)(4).The incidence of gallbladder stones in patients undergoing radical proximal gastrectomy was statistically different(P<0.05).The incidence of postoperative gallbladder stones(5.9%)was lower in patients who underwent dual-channel jejunal interval than in patients who underwent single-channel jejunal space(7.5%)and(21.2%)with traditional esophageal residual.(5).The incidence of gallbladder stones in patients undergoing radical total gastrectomy was not statistically significant(P>0.05).In addition,the incidence of postoperative gallbladder stones(18.9%)was approximately the same as that of postcolonic patients(18.6%).(6).The incidence of gallbladder stones in patients undergoing radical distal gastrectomy was not statistically significant(P>0.05).The incidence of postoperative gallbladder stones in patients undergoing Billroth ?+Brown anastomosis(8%)was lower than that in patients undergoing Billroth ? anastomosis(16.1%).Conclusions:Patients with age>65,body mass index(BMI)? 23 kg/m2,preoperative fasting blood glucose abnormalities(FPG>6.1 mmol/1),and hyperlipidemia are more likely to develop gallbladder stones after radical gastrectomy.Regardless of whether the gallbladder is normal before surgery,it is not recommended to remove the gallbladder at the same time during radical gastrectomy in view of the adverse effect on the quality of life of the patient after the gallbladder removed.Prophylactic cholecystectomy might be considered in patients with age>65,body mass index(BMI)?23 kg/m2,preoperative fasting blood glucose abnormalities(FPG>6.1 mmol/1),and hyperlipidemia.