胃切除术式对术后并发胆囊结石的影响

目的：探讨胃切除手术方式及胃肠重建方式对术后并发胆囊结石的影响。方法：对316例胃切除术患者于术后随访2年,观察其术后并发胆囊结石的发病情况,并按照其胃切除术式及胃肠重建方式的不同进行分组分析。结果：①62例（19.62%）并发胆囊结石,发病率高于自然人群（10.00%,P〈0.05）;②远端胃切除术后并发胆囊结石发病率（17.56%）明显低于近端胃切除术（35.14%）者,差异有统计学意义（P〈0.05）;③各亚组之间比较,近端胃切除及食管残胃吻合术组术后并发胆囊结石发病率（36.00%）最高,而远端胃切除及行BillrothⅠ式吻合术组发病率（5.13%）最低;远端胃切除及行BillrothⅠ式吻合术组与各亚组之间的差异有高度统计学意义（P均〈0.01）;其余各亚组之间比较差异无统计学意义（P均〉0.05）。结论：胃切除术后胆囊结石发病率增高,切除术式、及胃肠重建方式在胆囊结石发生机制中起重要作用。

Impact of gastrectomy on postoperative complicated gallstone

Objective： To investigate me impact of gastrectomy and gastrointestinal reconstruction on postoperative complicated gallstone. Methods： Three hundred and sixteen cases of gastrectomy patients were followed up of 2 years after operation, the postoperative incidence of gallbladder calculus were observed; the patients were divided into groups and analyzed according the different ways of gastrectomy and gastrointestinal reconstruction. Results：①62 cases （19.62%） of concurrent gallbladder calculus, the incidences were higher than that of natural population （10.00%, P〈0.05）; ②The incidences of gallstone after distal gastrectomy （17.56%） were significantly lower than that of the proximal gastrectomy（35.14%）, difference was statistically significant （P〈0.05）; ③Comparison between the various subgroups： The incidence of postoperative gallbladder calculus of proximal gastrectomy and residual gastric esophageal anastomosis group （36.00%） was the highest, the incidence of distal gastrectomy and Billroth I line type anastomosis group （5.13%） was the lowest; The differences of the incidence of distal gastrectomy and Billroth I line type anastomosis group between the various subgroups were highly statistically significant （all P〈0.01）; The differences between the other subgroups were not statistically significant （P〉0.05）. Conclusion： The incidence of gallbladder calculus after gastreetomy will increase, surgical resection and gastrointestinal reconstruction methods play an important role in the pathogenesis of gallbladder stones.