Gallstone formation after gastrectomy for adenocarcinoma of the stomach

Abstract Background/Introduction An increased incidence of gallstones after gastrectomy has been reported, but with varying risk factors. Purposes/Aims To delineate the incidence of and risk factors for gallstone formation after gastrectomy. Methods We retrospectively analyzed patients with Stages 0, I, and II adenocarcinoma of the stomach who had undergone curative gastrectomy with routine lymph node dissection between August 1996 and November 2010. We reviewed the clinical factors, radiographic presentation of the gallstones, and follow-up records. Results We included 215 patients (124 men and 91 women), with a median age of 53 years (range, 16–89 years). Gallstones were observed in 46 patients (21.4%) during follow-up periods of 6 months–14.5 years. Gallstones were diagnosed at a median of 2.3 years after gastrectomy. The cumulative incidence of gallstones at 5 years and 10 years was 18% and 20%, respectively. Total gastrectomy, Billroth II reconstruction (vs. Billroth I), age ≥ 60 years, and diabetes mellitus (multivariate odds ratios of 3.8, 3.3, 2.7, and 2.6, respectively) were the risk factors for gallstone formation. Complicated cholelithiasis was identified in seven patients (15.2% of patients with gallstones and 3.3% of all patients) and was more prevalent in patients who had undergone total gastrectomy (5 of 14; 35.7%) than in those who had undergone subtotal gastrectomy (2 of 32; 6.2%; p  = 0.02). Conclusion The incidence of gallstone formation was 21.4%. Total gastrectomy, Billroth II reconstruction, age ≥ 60 years, and diabetes mellitus were risk factors for gallstone formation. Total gastrectomy is also a risk factor for complicated gallstone.