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World Journal of Surgery

, Volume 29, Issue 2, pp 182–186 | Cite as

Gallstone Disease after Extended (D2) Lymph Node Dissection for Gastric Cancer

  • Tomotaka Akatsu
  • Masashi Yoshida
  • Tetsuro Kubota
  • Motohide Shimazu
  • Masakazu Ueda
  • Yoshihide Otani
  • Go Wakabayashi
  • Koichi Aiura
  • Minoru Tanabe
  • Toshiharu Furukawa
  • Yoshiro Saikawa
  • Shigeyuki Kawachi
  • Yukako Akatsu
  • Koichiro Kumai Masaki Kitajima
Original Scientific Report

Abstract

Few studies have reported the incidence and clinical outcomes of gallstone disease after extended (D2) lymph node dissection for gastric cancer. The present study was designed to retrospectively compare limited (D1) and D2 dissections in terms of gallstone formation, presentation of gallstones, and surgery for gallstone disease. A total of 805 Japanese gastric cancer patients (595 male, 210 female) who underwent curative resection with D1 (n = 490) or D2 (n = 315) dissection were retrospectively reviewed. Of those subjects followed for 70.5 ± 44.3 months (range: 2-196 months), 102 (12.7%) developed gallstones. The incidence of gallstone formation was higher in the D2 group than in the D1 group (17.8% vs. 9.4%, p = 0.001). The interval between gastrectomy and detection of gallstones was shorter in the D2 group than in the Dl group (18.8 ± 11.4 months vs. 29.4 ± 18.3 months, p = 0.002). Of those with gallstones followed for 48.0 ± 28.6 months (range: 1-158 months), 74 (72.5%) remained asymptomatic, and 15 (14.7%) experienced mild biliary pain. Thirteen patients (12.7%) developed recurrent biliary pain (n = 3) or biliary complications (n = 10; 6 acute cholecystitis, 3 obstructive jaundice, and 1 cholangitis), and required surgical treatment. Surgery was more frequently sought in the D2 group than in the D1 group (19.5% vs. 4.3%, p = 0.033). In conclusion, patients with D2 dissection developed gallstones more frequently and earlier than patients with D1 dissection. Of those with gallstones, patients with D2 dissection required surgery more often than patients with D1 dissection. A closer follow-up should be mandatory for gallstone disease after D2 dissection, but further studies are needed before generalizations can be made.

Keywords

Gastric Cancer Laparoscopic Cholecystectomy Acute Cholecystitis Obstructive Jaundice Gallbladder Carcinoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Société Internationale de Chirurgie 2005

Authors and Affiliations

  • Tomotaka Akatsu
    • 1
  • Masashi Yoshida
    • 1
  • Tetsuro Kubota
    • 1
  • Motohide Shimazu
    • 1
  • Masakazu Ueda
    • 1
  • Yoshihide Otani
    • 1
  • Go Wakabayashi
    • 1
  • Koichi Aiura
    • 2
  • Minoru Tanabe
    • 1
  • Toshiharu Furukawa
    • 1
  • Yoshiro Saikawa
    • 1
  • Shigeyuki Kawachi
    • 1
  • Yukako Akatsu
    • 1
  • Koichiro Kumai Masaki Kitajima
    • 1
  1. 1.Department of SurgeryKeio University School of MedicineShinjyuku-kuJapan
  2. 2.Center for Diagnostic and Therapeutic EndoscopyKeio University School of MedicineShinjyuku-kuJapan

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