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Cholelithiasis after stomach cancer surgical treatment: is preventive cholecystectomy justified?


The presented review is devoted to the problem of cholelithiasis at patients with stomach cancer after surgical treatment, because its frequency for 5 years has been increasing for 3–4 times, being 15–45.2 %. The basic reason of development is crossing of nervus vagus and its branches during surgical intervention and also reconstruction of the digestive tract and lymph node dissection. The pointed influence leads to disfunction of neuro-humoral mechanisms of biliary excretion regulation, accompanied by the disturbance of tone of gall, appearance of biliary sludge and stratification of the content of gall at echonegative and echopositive layers of bile with the following formation of calculus. Because of this some authors propose to carry preventive cholecystectomy simultaneously with surgical intrusion. The results of randomized research CHOLEGAS, according to which the accompanying cholecystectomy does not increase the frequency of surgical and general complications are presented. This intrusion improves the quality of life of patients with stomach cancer after surgical treatment.


stomach cancer; surgical treatment; cholelithiasis; pathogenesis; preventive cholecystectomy

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1. Yamazaki H., Oshima A., Murakami R. et al. A long-term follow-up study of patients with gastric cancer detected by mass screening. Cancer, 1989, vol. 63, pp. 613-617. 2. Itoh H., Oohata Y., Nakamura K. et al. Complete ten-year postgastrectomy follow-up of early gastric cancer. Am. J. Surg., 1989, vol. 158, pp. 14-16. 3. Lee H.J., Yang H.K., Ahn Y.O. Gastric cancer in Korea. Gastric Cancer, 2002, vol. 5, pp. 177-182. 4. Carter K.J., Schaffer H.A., Ritchie W.P. Jr. Early gastric cancer. Ann. Surg., 1984, vol. 199, pp. 604-609. 5. Kim Y.S., Park H.A., Kim B.S. et al. Efficacy of screening for gastric cancer in a Korean adult population: a case-control study. J. Korean Med. Sci., 2000, vol. 15, pp. 510-515. 6. Inoue K., Fuchigami A., Higashide S. et al. Gallbladder sludge and stone formation in relation to contractile function after gastrectomy. A prospective study. Ann. Surg., 1992, vol. 215, pp. 19-26. 7. Hauters P., de Neve de Roden A., Pourbaix A. et al. Cholelithiasis: a serious complication after total gastrectomy. Br. J. Surg., 1988, vol. 75, pp. 899-900. 8. Ura K., Sarna S.K., Condon R.E. Antral control of gallbladder cyclic motor activity in the fasting state. Gastroenterology, 1992, vol. 102, pp. 295-302. 9. Kyu-hyun Paik, Jong-Chan Lee, Hyoung Woo Kim, Jingu Kang, Yoon Suk Lee, Jin-Hyeok Hwang, Sang Hoon Ahn, Do Joong Park, Hyung-Ho Kim, Jaihwan Kim Risk Factors for Gallstone Formation in Resected Gastric Cancer Patients. Medicine (Baltimore), 2016, vol. 95 (15), p. e3157. 10. Kobayashi T., Hisanaga M., Kanehiro H., Yamada Y., Ko S., Nakajima Y. Analysis of risks factors for the development of gallstones after gastrectomy. Br. J. Surg., 2005, vol. 92, pp. 1399-1403. DOI: 10.1002/bjs.5117. 11. Sanders G., Kingsnorth A.N. Gallstones. BMJ, 2007, vol. 335, pp. 295-299. 12. Sakorafas G.H., Milingos D., Peros G. Asymptomatic Cholelithiasis: Is Cholecystectomy Really Needed? Dig. Dis. Sci., 2007, vol. 52, pp. 1313-1325. 13. Fukagawa T., Katai H., Saka M., Morita S., Sano T., Sasako M. Gallstone Formation after Gastric Cancer Surgery. J. Gastrointest. Surg., 2009, vol. 13, pp. 886-889. 14. Jayakrishnan T.T., Groeschl R.T., George B. et al. Review of the Impact of Antineoplastic Therapies on the Risk for Cholelithiasis and Acute Cholecystitis. Ann. Surg. Oncol., 2014, vol. 21, p. 240. 15. Lomtev N.G. Patologiya obmena, gormonal'noy regulyatsii, organnykh funktsiy tonkoy kishki i pishchevaritel'nykh zhelez do i posle khirurgicheskogo lecheniya raka zheludka. Avtoref. diss. dokt. med. nauk [Pathology of Exchange, Hormonal Regulation, Organistic Functions of Small Intestine and Digestive Glands Before and After Surgical Treatment of Stomach Cancer. Dr. med. sci. diss. abstr.]. Dushanbe, 2015. (In Russian). 16. Wu C.C., Chen C.Y., Wu T.C. et al. Cholelithiasis and cholecystitis after gastrectomy for gastric carcinoma: a comparison of lymphadenectomy of varying extent. Hepatogastroenterology, 1995, vol. 42, pp. 867-872. 17. 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, vol. 178, pp. 581-586. 18. Rehnberg O., Haglund U. Gallstone disease following antrectomy and gastroduodenostomy with or without vagotomy. Ann. Surg., 1985, vol. 201, pp. 315-318. 19. Tomita R., Tanjoh K., Fujisaki S. Total gastrectomy reconstructed by interposition of a jejunal J pou with preservation of hepatic vagus branch and lower esophageal sphincter for T2 gastric cancer without lymph node metastasis. Hepatogastroenterology, 2004, vol. 51, pp. 1233-1240. 20. Akatsu T., Yoshida M., Kubota T., Shimazu M., Ueda M., Otani Y. et al. Gallstone Disease after Extended (D2) Lymph Node Dissection for Gastric Cancer. World J. Surg., 2005, vol. 29, pp. 182-186. 21. Qvist N. Review article: gall-bladder motility after intestinal surgery. Aliment Pharmacol. Ther., 2000, vol. 14 (s2), pp. 35-38. 22. Yi S.Q., Ohta T., Tsuchida A. et al. Surgical anatomy of innervation of the gallbladder in humans and Suncus murinus with special reference to morphological understanding of gallstone formation after gastrectomy. World J. Gastroenterol., 2007, vol. 14, pp. 2066-2071. 23. Watemberg S., Landau O., Avrahami R. et al. Incidental cholecystectomy in the over-70 age group. A 19-year retrospective, comparative study. Int. Surg., 1997, vol. 82, pp. 102-104. 24. Pezzolla F., Lantone G., Guerra V. et al. Influence of the method of digestive tract reconstruction on gallstone development after total gastrectomy for gastric cancer. Am. J. Surg., 1993, vol. 166, pp. 6-10. 25. Lundman T., Orinius E., Thorsen G. Incidence of gallstone disease following partial gastric resection. Acta Chir. Scand., 1964, vol. 127, p. 130-133. 26. Clave R.A., Gaspar M.R. Incidence of gallbladder disease after vagotomy. Am. J. Surg., 1969, vol. 118, p. 169. 27. Cox H.T., Doherty J.F., Kerr D.F. Changes in the gallbladder after elective gastric surgery. Lancet, 1958, vol. 1, p. 764. 28. Tompkins R.K., Kraft A.R., Zimmerman E. et al. Clinical and biochemical evidence of increased gallstone formation after complete vagotomy. Surgery, 1972, vol. 71, p. 196. 29. Rudick J., Hutchison J.S.F. Evaluation of vagotomy and biliary function by combined oral cholecystography and intravenous cholangiography. Ann. Surg., 1965, vol. 162, p. 234. 30. 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, vol. 199, pp. 276-280. 31. Masclee A.A., Jansen J.B., Driessen W.M. et al. Delayed plasma cholecystokinin and gallbladder responses to intestinal fat in patients with Billroth I and II gastrectomy. Surgery, 1989, vol. 106, pp. 502-508. 32. Barbara L., Sama C., Morselli Labate A.M. et al. A population study on the prevalence of gallstone disease: the Sirmione Study. Hepatology, 1987, vol. 7, pp. 913-917. 33. Biddinger S.B., Haas J.T., Yu B.B. et al. Hepatic insulin resistance directly promotes formation of cholesterol gallstones. Nat. Med., 2008, vol. 14, pp. 778-782. 34. Sasazuki S., Kono S., Todoroki I. et al. Impaired glucose tolerance, diabetes mellitus, and gallstone disease: an extended study of male self-defense officials in Japan. Eur. J. Epidemiol., 1999, vol. 15, pp. 245-251. 35. Nakamura K., Ogoshi K., Makuuchi H. Clinicopathological study of cholelithiasis following gastric cancer surgery. Eur. Surg. Res., 2005, vol. 37, pp. 29-35. 36. Krause U. Long term results of medical and surgical treatment for peptic ulcer. Acta Chir. Scand., 1963, vol. 310, p. 1. 37. Takahashi T., Yamamura T., Yokoyama E. et al. Impaired contractile motility of the gallbladder after gastrectomy. Am. J. Gastroenterol., 1986, vol. 81, pp. 672-677. 38. Takahashi T., Yamamura T., Utsunomiya J. Pathogenesis of acute cholecystitis after gastrectomy. Br. J. Surg., 1990, vol. 77, pp. 536-539. 39. Fletcher D.M., Clark C.G. Gall-stones and gastric surgery. A review. Br. J. Surg., 1968, vol. 55, pp. 895-899. 40. Lomtev N.G. Gepatobiliarnyy transport i zhelchnye kisloty do i posle khirurgicheskogo lecheniya raka zheludka [Hepatobiliary transport and bile acids before and after gastric surgery]. Vestnik Tambovskogo universiteta. Seriya Estestvennye i tekhnicheskie nauki – Tambov University Reports. Series: Natural and Technical Sciences, 2014, vol. 19, no. 6, pp. 1934-1936. (In Russian). 41. Lomtev N.G. Osobennosti vozniknoveniya i progressirovaniya kholelitiaza posle total'noy gastrektomii i rezektsii po povodu raka zheludka [Peculiarities of appearance and progressing of cholelithiasis after total gastrectomy and exsection about stomach cancer]. Vestnik Kyrgyzsko-Rossiyskogo Slavyanskogo universiteta [A Herald of Kirghiz-Russian Slavonic University], 2014, vol. 14, no. 10. pp. 137-140. (In Russian). 42. Lomtev N.G. Gastrin i pishchevaritel'nye fermenty v krovi bol'nykh rakom zheludka do i posle total'noy gastrektomii [Gastrin and digestive enzyme in blood of patients before and after total gastrectomy]. Vestnik Kyrgyzsko-Rossiyskogo Slavyanskogo universiteta [A Herald of Kirghiz-Russian Slavonic University], 2014, vol. 14, no 4, pp. 113-116. (In Russian). 43. Juhasz E.Z., Wolff B.G., Meagher A.P. et al. Incidental cholecystectomy during colorectal surgery. Ann. Surg., 1994, vol. 219, pp. 467-474. 44. Wolff B.G. Current status of incidental surgery. Dis. Colon. Rect., 1995, vol. 38, pp. 435-441. 45. Sasaki A., Nakajima J., Nitta H. et al. Laparoscopic cholecystectomy in patients with a history of gastrectomy. Surg. Today, 2008, vol. 38, pp. 790-794. 46. Fraser S.A., Sigman H. Conversion in laparoscopic cholecystectomy after gastric resection: a 15-year review. Can. J. Surg., 2009, vol. 52, pp. 463-466. 47. Gillen S., Michalski C.W., Schuster T. et al. Simultaneous/incidental cholecystectomy during gastric/esophageal resection: systematic analysis of risks and benefits. World J. Surg., 2010, vol. 34, pp. 1008-1014. 48. Oh S.J., Choi W.B., Song J. et al. Complications requiring reoperation after gastrectomy for gastric cancer: 17 years experience in a single institute. J. Gastrointest. Surg., 2009, vol. 13, pp. 239-245. 49. Liu X.S., Zhang Q., Zhong J. et al. Acute cholecystitis immediately after radical gastrectomy: a report of three cases. World J. Gastroenterol., 2010, vol. 16, pp. 2702-2704. 50. Miftode S.V., Troja A., El-Sourani N., Raab H.R., Antolovic D. Simultaneous cholecystectomy during gastric and oesophageal resection: a retrospective analysis and critical review of literature. Int. J. Surg., 2014, vol. 12 (12), pp. 1357-1359. 51. Kim J., Cho J.N., Joo S.H., Kim B.S., Lee S.M. Multivariable analysis of cholecystectomy after gastrectomy: laparoscopy is a feasible initial approach even in the presence of common bile duct stones or acute cholecystitis. World J. Surg., 2012, vol. 36, pp. 638-644. 52. Ung Ho Shim, Cho Hyun Park, Kyo Young Song Can prophylactic cholecystectomy be justified? Gastric Cancer, 2013, vol. 16, no. 3, pp. 445-446. 53. Ando S., Tsuji H. Surgical technique of vagus nerve-preserving gastrectomy with D2 lymphadenectomy for gastric cancer. ANZ J. Surg., 2008, vol. 78, pp. 172-176. 54. Farsi M., Bernini M., Bencini L., Miranda E., Manetti R., de Manzoni G., Verlato G., Marrelli D., Pedrazzani C., Roviello F., Marchet A., Cristadoro L., Gerard L. GIRCG (Gruppo Italiano di Ricerca sul Cancro Gastrico). The CHOLEGAS study: multicentric randomized, blinded, controlled trial of gastrectomy plus prophylactic cholecystectomy versus gastrectomy only, in adults submitted to gastric cancer surgery with curative intent. Trials, 2009, vol. 15 (10), p. 32. 55. Bernini M., Bencini L., Sacchetti R., Marchet A., Cristadoro L., Pacelli F., Berardi S., Doglietto G.B., Rosa F., Verlato G., Cozzaglio L., Bechi P., Marrelli D., Roviello F., Farsi M. Italian Research Group for Gastric Cancer (IRGGC). The Cholegas Study: safety of prophylactic cholecystectomy during gastrectomy for cancer: preliminary results of a multicentric randomized clinical trial. Gastric Cancer, 2013, vol. 16, pp. 370-376.



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