Abstract
In a prospective trial to determine whether gastric surgery induces gallbladder sludge and stone formation, 48 patients with gastric cancer were ultrasonographically examined with simultaneous observation on changes in gallbladder contractile function before and serially for 5 years after gastrectomy. Gallbladder sludge formation was induced with a high frequency of 42% 1 month after gastrectomy, with corresponding significant lowering of gallbladder contractile function. Most of gallbladder sludges, however, disappeared within 12 months in relation to the gradual recovery of gallbladder contractile function. Conversely, gallstone developed in nine patients (18.8%), mostly more than 6 months after gastrectomy. Interestingly, gallstone formation was induced in seven patients who were sludge negative. An evolvement of gallbladder sludge into stone was observed in only two patients, who were, however, treated with intravenous hyperalimentation. This study first provides evidence for the relationship between gastrectomy and a considerably high frequency of incidence of gallbladder sludge and stone in relation to changes in gallbladder kinetics after gastrectomy.
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- Allen B., Bernhoft R., Blanckaert N., Svanvik J., Filly R., Gooding G., Way L. Sludge is calcium bilirubinate associated with bile stasis. Am J Surg. 1981 Jan;141(1):51–56. doi: 10.1016/0002-9610(81)90011-8. [DOI] [PubMed] [Google Scholar]
- Anderson J. R., Ross A. H., Din N. A., Small W. P. Cholelithiasis following peptic ulcer surgery: a prospective controlled study. Br J Surg. 1980 Sep;67(9):618–620. doi: 10.1002/bjs.1800670904. [DOI] [PubMed] [Google Scholar]
- Bolondi L., Gaiani S., Testa S., Labò G. Gall bladder sludge formation during prolonged fasting after gastrointestinal tract surgery. Gut. 1985 Jul;26(7):734–738. doi: 10.1136/gut.26.7.734. [DOI] [PMC free article] [PubMed] [Google Scholar]
- COX H. T., DOHERTY J. F., KERR D. F. Changes in the gallbladder after elective gastric surgery. Lancet. 1958 Apr 12;1(7024):764–766. doi: 10.1016/s0140-6736(58)91575-7. [DOI] [PubMed] [Google Scholar]
- Conrad M. R., Janes J. O., Dietchy J. Significance of low level echoes within the gallbladder. AJR Am J Roentgenol. 1979 Jun;132(6):967–972. doi: 10.2214/ajr.132.6.967. [DOI] [PubMed] [Google Scholar]
- Filly R. A., Allen B., Minton M. J., Bernhoft R., Way L. W. In vitro investigation of the origin of echoes with biliary sludge. J Clin Ultrasound. 1980 Jun;8(3):193–200. doi: 10.1002/jcu.1870080302. [DOI] [PubMed] [Google Scholar]
- Fletcher D. M., Clark C. G. Gall-stones and gastric surgery. A review. Br J Surg. 1968 Dec;55(12):895–899. doi: 10.1002/bjs.1800551205. [DOI] [PubMed] [Google Scholar]
- GRIFFITHS J. M., HOLMES G. CHOLECYSTITIS FOLLOWING GASTRIC SURGERY. Lancet. 1964 Oct 10;2(7363):780–782. doi: 10.1016/s0140-6736(64)90560-4. [DOI] [PubMed] [Google Scholar]
- HORWITZ A., KIRSON S. M. CHOLECYSTITIS AND CHOLELITHIASIS AS A SEQUEL TO GASTRIC SURGERY: A CLINICAL IMPRESSION. Am J Surg. 1965 Jun;109:760–762. doi: 10.1016/s0002-9610(65)80048-4. [DOI] [PubMed] [Google Scholar]
- Hopman W. P., Jansen J. B., Lamers C. B. Plasma cholecystokinin response to a liquid fat meal in vagotomized patients. Ann Surg. 1984 Dec;200(6):693–697. doi: 10.1097/00000658-198412000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hopman W. P., Jansen J. B., Lamers C. B. Plasma cholecystokinin response to oral fat in patients with Billroth I and Billroth II gastrectomy. Ann Surg. 1984 Mar;199(3):276–280. doi: 10.1097/00000658-198403000-00005. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Inoue K., Fuchigami A., Hosotani R., Kogire M., Huang Y. S., Miyashita T., Suzuki T., Tsuda K., Seino Y., Rayford P. L. Release of cholecystokinin and gallbladder contraction before and after gastrectomy. Ann Surg. 1987 Jan;205(1):27–32. [PMC free article] [PubMed] [Google Scholar]
- Inoue K., Tobe T., Kan N., Nio Y., Sakai M., Takeuchi E., Sugiyama T. Problems in the definition and treatment of early gastric cancer. Br J Surg. 1991 Jul;78(7):818–821. doi: 10.1002/bjs.1800780717. [DOI] [PubMed] [Google Scholar]
- Inoue K., Wiener I., Fagan C. J., Watson L. C., Thompson J. C. Correlation between gallbladder size and release of cholecystokinin after oral magnesium sulfate in man. Ann Surg. 1983 Apr;197(4):412–415. doi: 10.1097/00000658-198304000-00006. [DOI] [PMC free article] [PubMed] [Google Scholar]
- JOHNSON F. E., BOYDEN E. A. The effect of double vagotomy on the motor activity of the human gall bladder. Surgery. 1952 Sep;32(3):591–601. [PubMed] [Google Scholar]
- LUNDMAN T., ORINIUS E., THORSEN G. INCIDENCE OF GALLSTONE DISEASE FOLLOWING PARTIAL GASTRIC RESECTION. Acta Chir Scand. 1964 Jan-Feb;127:130–133. [PubMed] [Google Scholar]
- Lilja P., Fagan C. J., Wiener I., Inoue K., Watson L. C., Rayford P. L., Thompson J. C. Infusion of pure cholecystokinin in humans. Correlation between plasma concentrations of cholecystokinin and gallbladder size. Gastroenterology. 1982 Jul;83(1 Pt 2):256–261. [PubMed] [Google Scholar]
- MAJOOR C. L. H., SUREN T. J. J. Gall-bladder complications following resection of the stomach for peptic ulcer. Br Med J. 1947 Jul 5;2(4513):8–11. doi: 10.1136/bmj.2.4513.8. [DOI] [PMC free article] [PubMed] [Google Scholar]
- MacGregor I., Parent J., Meyer J. H. Gastric emptying of liquid meals and pancreatic and biliary secretion after subtotal gastrectomy or truncal vagotomy and pyloroplasty in man. Gastroenterology. 1977 Feb;72(2):195–205. [PubMed] [Google Scholar]
- Masclee A. A., Jansen J. B., Driessen W. M., Geuskens L. M., Lamers C. B. Delayed plasma cholecystokinin and gallbladder responses to intestinal fat in patients with Billroth I and II gastrectomy. Surgery. 1989 Sep;106(3):502–508. [PubMed] [Google Scholar]
- Maudgal D. P., Kupfer R. M., Zentler-Munro P. L., Northfield T. C. Postprandial gall-bladder emptying in patients with gall stones. Br Med J. 1980 Jan 19;280(6208):141–143. doi: 10.1136/bmj.280.6208.141. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Messing B., Bories C., Kunstlinger F., Bernier J. J. Does total parenteral nutrition induce gallbladder sludge formation and lithiasis? Gastroenterology. 1983 May;84(5 Pt 1):1012–1019. [PubMed] [Google Scholar]
- Parkin G. J., Smith R. B., Johnston D. Gallbladder volume and contractility after truncal, selective and highly selective (parietal-cell) vagotomy in man. Ann Surg. 1973 Nov;178(5):581–586. doi: 10.1097/00000658-197311000-00005. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pitt H. A., King W., 3rd, Mann L. L., Roslyn J. J., Berquist W. E., Ament M. E., DenBesten L. Increased risk of cholelithiasis with prolonged total parenteral nutrition. Am J Surg. 1983 Jan;145(1):106–112. doi: 10.1016/0002-9610(83)90175-7. [DOI] [PubMed] [Google Scholar]
- RUDICK J., HUTCHISON J. S. EFFECTS OF VAGAL-NERVE SECTION ON THE BILIARY SYSTEM. Lancet. 1964 Mar 14;1(7333):579–581. doi: 10.1016/s0140-6736(64)91330-3. [DOI] [PubMed] [Google Scholar]
- Rehnberg O., Haglund U. Gallstone disease following antrectomy and gastroduodenostomy with or without vagotomy. Ann Surg. 1985 Mar;201(3):315–318. doi: 10.1097/00000658-198503000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sapala M. A., Sapala J. A., Soto A. D., Bouwman D. L. Cholelithiasis following subtotal gastric resection with truncal vagotomy. Surg Gynecol Obstet. 1979 Jan;148(1):36–38. [PubMed] [Google Scholar]
- TURUNEN M., ANTILA L. GALLBLADDER DISEASE FOLLOWING GASTRECTOMY. Acta Chir Scand. 1964 Jan-Feb;127:134–137. [PubMed] [Google Scholar]
- Williams E. J., Irvine W. T. Functional and metabolic effects of total and selective vagotomy. Lancet. 1966 May 14;1(7446):1053–1057. doi: 10.1016/s0140-6736(66)91006-3. [DOI] [PubMed] [Google Scholar]