Evaluation of the Vagus Preserving Gastrectomy Aiming at Prevention of Postgastrectomy Gallstone Formation

Hidetoshi Suzuki, Yasunori Mikami, Kageyoshi Seino, Toshiaki Baba, Shuu Takahashi, Hitoshi Kawasaki, Kenichi Hakamada, Masaaki Endoth, Yuzuru Sugiyama*, Mutsuo Sasaki

Second Department of Surgery, Hirosaki University School of Medicine, College of Biomedical Technology, Hirosaki University*

The following are the results of a clinical review of 111 patients treated by the vagus-preserving gastrectomy aimed at prevention of postgastrectomy gallstone formation (the pylorus was preserved in 53 patients and not preserved in 58). The overall incidence of gallstone formation in these patients was 10.8% (12/111). The frequencies of gallstone formation for 4 types of vagus preservation were 14.8% (8/54) for the basic hepatic branch preservation type, 12.5% (2/16) for the hepatic+pyloric branches type, 7.4% (2/27) for the hepatic+celiac branches type, and 0.0% (0/14) for the hepatic+celiac+pyloric branches type. The frequency according to whether or not the celiac branch was preserved was 4.9% (2/41) for celiac branch preservation, and 14.3% (10/70) without celiac branch preservation. It was lower for the former though the difference between two groups was no significant. The frequency according to whether or not the pylorus was preserved was 11.3% (6/53) for pylorus preservation, and 10.3% (6/58) without pylorus preservation. The above results suggest that the celiac branch, in addition to the hepatic branch, should be preserved in preventing postgastrectomy gallstone formation. The pylorus preservation was considered to have little significance.

Key words
prevention of postgastrectomy gallstone, vagus preserving gastrectomy, pylorus preserving gastrectomy

Reprint requests
Hidetoshi Suzuki Second Department of Surgery, Hirosaki University School of Medicine
5 Zaifuchou, Hirosaki, 036-8216 JAPAN

Accepted
November 5, 1997

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