Abstract
Cholelithiasis is known to occur in 15%–24.5% of proctocolectomized patients. However, the clinical features and chemical analysis of gallstones in these patients have not been reported. We describe two cases of cholelithiasis that developed in patients after proctocolectomy with ileoanal anastomosis. These patients had a high output of watery stools and more frequent bowel movements than the average for Japanese patients with ileoanal anastomosis. The chemical composition of the resected gallstones was 93.0% cholesterol and 80.9%, respectively, in the two patients, indicating that cholesterol gallstones are formed in patients with ileoanal anastomosis after proctocolectomy.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Santos MC, Thompson JS. Late complications of the ileal pouch-anal anastomosis. Am J Gastroenterol 1993;88:3–10.
Nasmyth DG, Johnston D, Williams NS, et al. Changes in the absorption of bile acids after total colectomy in patients with an ileostomy or pouch-anal anastomosis. Dis Colon Rectum 1989; 32:230–234.
Santavirta J, Mattila J, Kokki M, et al. Absorption of bile acids after ileoanal anastomosis. Ann Chir Gynecol 1990;79:134–138.
Hill GL, Mair WSJ, Goligher JC. Gallstones after ileostomy and ileal resection. Gut 1975;16:932–936.
Kurchin A, Ray JE, Bluth EI, et al. Cholelithiasis in ileostomy patients. Dis Colon Rectum 1984;27:585–588.
Harvey PRC, Mcleod RS, Cohen Z, et al. Effect of colectomy on bile composition, cholesterol crystal formation, and gallstones in patients with ulcerative colitis. Ann Surg 1991;214:396–402.
Itoh H, Nakahara S, Nakamura K, et al. Bile composition after total proctocolectomy with interposed jejunal segments as neorectum. Dis Colon Rectum 1989;32:711–715.
Chijiiwa K. Clinical and chemical characteristics of gallstone disease in Japan. Asian J Surg 1991;14:79–83.
Utsunomiya J, Iwama T. The J ileal pouch-anal anastomosis: The Japanese experience. In: Dozois RR (ed) Alternatives to conventional ileostomy. Chicago: Year Book Medical 1985; 371–383.
Natori H, Utsunomiya J, Yamamura T, et al. Fecal and stomal bile acid composition after ileostomy or ileoanal anastomosis in patients with chronic ulcerative colitis and adenomatosis coli. Gastroenterology 1992;102:1278–1288.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Mibu, R., Makino, I. & Chijiiwa, K. Gallstones and their composition in patients with ileoanal anastomosis. J Gastroenterol 30, 413–415 (1995). https://doi.org/10.1007/BF02347521
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02347521