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The Effect of Minimally Invasive Gastrectomy for Gastric Cancer on Postoperative Gallstone Formation

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Abstract

Background

Gallstones are known to occur quite frequently after gastrectomy. Most of the studies about postoperative cholelithiasis have focused on open gastrectomy, whereas laparoscopic gastrectomy has recently gained popularity as a type of minimally invasive surgery (MIS). Hence, the efficacy of MIS in preventing post-gastrectomy gallstone formation remains to be elucidated. This study aimed to evaluate the risk of gallstone formation after MIS for clinical stage I/IIA gastric cancer.

Methods

A total of 1166 patients undergoing gastrectomy for clinical stage I/IIA gastric cancer between 2009 and 2016 were included in this study. Gallstones were detected on abdominal ultrasound and/or computed tomography. Multivariate logistic regression analysis was used to determine factors associated with postoperative gallstone formation.

Results

Gallstone formation was observed in 174 patients (15%), of whom 22 (2%) experienced symptomatic cholelithiasis. In multivariate analysis, the following were identified as risk factors for post-gastrectomy gallstone formation: open approach with an odds ratio (OR) of 1.670 and a 95% confidence interval (CI) of 1.110–2.510 (P = 0.014), older age (OR 1.880; 95% CI 1.290–2.730; P < 0.001), high body mass index (OR 1.660; 95% CI 1.140–2.420; P = 0.008), Roux-en-Y (RY) reconstruction (OR 1.770; 95% CI 1.230–2.530; P = 0.002), hepatic branch vagotomy (OR 1.600; 95% CI 1.050–2.440; P = 0.029), and intra-abdominal infectious complications (OR 3.040; 95% CI 1.680–5.490; P < 0.001).

Conclusion

Our study suggested that MIS along with the preservation of the hepatic vagus nerve and non-RY reconstruction could help prevent post-gastrectomy gallstone development.

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Acknowledgements

The authors had no financial support for the research reported.

Funding

The funding sources were not involved in this study.

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Authors and Affiliations

  1. Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun 411-8777, Shizuoka, Japan

    Ko Ikegame, Makoto Hikage, Keiichi Fujiya, Satoshi Kamiya, Yutaka Tanizawa, Etsuro Bando & Masanori Terashima

  2. Clinical Research Center, Shizuoka Cancer Center, Shizuoka, Japan

    Akifumi Notsu

Authors
  1. Ko Ikegame
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  2. Makoto Hikage
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  3. Keiichi Fujiya
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  7. Akifumi Notsu
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Correspondence to Masanori Terashima.

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Conflict of interest

Masanori Terashima has received personal fees from Taiho Pharmaceutical Co. Ltd., Chugai Pharmaceutical Co. Ltd., Eli Lilly Japan, Ono Pharmaceutical Co. Ltd., Bristol Myers Squibb Japan, and Yakult Honsha Co. Ltd. Etsuro Bando has received personal fees from the Eizo Corporation, Kanehara-Shuppan, Terumo Corporation, and Eisai. All other authors declare no conflicts of interest.

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Informed consent was waived by the ethical committee owing to the retrospective nature of the study.

Human and animal rights

This study was approved by the institutional review board of the Shizuoka Cancer Center (Approval No. J2020-95-2020-1-2).

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Ikegame, K., Hikage, M., Fujiya, K. et al. The Effect of Minimally Invasive Gastrectomy for Gastric Cancer on Postoperative Gallstone Formation. World J Surg 45, 3378–3385 (2021). https://doi.org/10.1007/s00268-021-06270-6

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  • DOI: https://doi.org/10.1007/s00268-021-06270-6

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