Current Status of Postgastrectomy Cholelithiasis in Japan -A Nationwide Survey Based on the Questionaire to the 133 Institutes-

Yoshio Tajima, Mikio Tezuka, Tsutomu Yaoita, Atsushi Kadowaki, Hiroaki Kogure

The Second Department of Surgery, Dokkyo University School of Medicine

In the 17th Congress of Japanese Society of Biliary Surgery, we reported a nationwide survey of postgastrectomy cholelithiasis, which has recently been attracting attention as one of the complications of gastrectomy. A total of 3,179 cases of postgastrectomy cholelithiasis were reported including 2,479 operated cases. We speculate that there might be many cases of asymptomatic cholelithiasis, juding from the fact that follow-up or conservatively treated cases were frequent. Gastrectomy was carried out for gastric cancer in the most cases. As for reconstruction, Billroth-1 and Billroth-2 type anastomoses were commonly performed. Pigment gallstones including calcium bilirubinate gallstones and blackstones were the most frequent as shown by macroscopic classification of the gallstones. The frequency of choledocholithiasis or intrahepatic lithiasis was high. Bacteria were frequencly detected in the bile of operated cases. The decreased gallbladder contractility, cholestasis and vagotomy were mainly considered attributable to the pathogenesis of postgastrectomy cholelithiasis.

Key words
cholelithiasis, postgastrectomy cholelithiasis, postgastrectomy disorders

Reprint requests
Mikio Tezuka The Second Department of Surgery, Dokkyo University School of Medicine
880 Kitakobayashi, Mibu, Tochigi, 321-02 JAPAN

Accepted
December 13, 1989

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