Combined cholecystectomy in gastric cancer surgery
Journal
International Journal of Surgery
Journal Volume
11
Journal Issue
4
Pages
305-308
Date Issued
2013
Abstract
Background: Many studies have described the risk factors of gallstone formation in gastric cancer patients after gastrectomy, but few studies focus on the management of asymptomatic gallstones. Our goal is to examine the rationale of simultaneous cholecystectomy during gastric cancer surgery, and influence of surgical mortality, morbidity and overall survival after combined cholecystectomy and gastrectomy. Methods: We retrospectively reviewed 445 gastric cancer patients and the gallbladders evaluated by abdominal ultrasound or computed tomography preoperatively and postoperatively. Clinicopathologic factors, including surgical morbidity, mortality and overall survival of combined surgery, were compared between patients receiving gastrectomy with simultaneous cholecystectomy and patients receiving gastrectomy only. We also evaluated the risk factors of gallstone formation after gastrectomy and the probability of subsequent cholecystectomy after gastrectomy in gastric cancer patients with or without asymptomatic gallstones. Results: Of 445 gastric cancer patients, 52 (11.7%) patients had asymptomatic gallstones upon diagnosis of gastric cancer. Among patients with healthy gallbladders, 15.2% developed gallstones after gastrectomy. Men and older patients (age over 60) had significantly higher risk of gallstone formation. Rate of subsequent cholecystectomy in patients with and without preoperative asymptomatic gallstones was 30.8% and 4.5%, respectively (p = 0.005). The rates of mortality and morbidity were not significantly different between combined surgery (3.4%, 24.2%) and gastrectomy only (3.1%, 22%). There was also no significant difference in 5-year survival between combined surgery (61%) and gastrectomy only (63%) groups. Conclusion: Combined cholecystectomy for asymptomatic gallstone in gastric cancer surgery may be considered. It was not associated with increased surgical morbidity or mortality, and had no significant effect on overall survival. ? 2013 Surgical Associates Ltd.
SDGs
Other Subjects
abdominal radiography; adult; aged; article; cancer recurrence; cancer surgery; cancer survival; cholecystectomy; female; follow up; gallbladder cancer; gallstone formation; gastrectomy; human; major clinical study; male; morbidity; overall survival; priority journal; retrospective study; risk factor; stomach cancer; surgical mortality; time; ultrasound; Adult; Aged; Aged, 80 and over; Cholecystectomy; Female; Gallstones; Gastrectomy; Humans; Male; Middle Aged; Postoperative Complications; Retrospective Studies; Stomach Neoplasms
Type
journal article