Clinical study of gallstones after gastrectomy, especialy elucidation of pathogenesis by the kinetics of cholecystic contractility and CCK secretion

• Published in: Tando Vol. 6; no. 2; pp. 123 - 131
• Main Authors: MIDORIKAWA, Takemasa, NAMATAME, Kimio, NARIHIRA, Kentarou, NAKAYOSHI, Akio
• Format: Journal Article
• Language: Japanese
• Published: Japan Biliary Association 1992
• ISSN: 0914-0077; 1883-6879
• DOI: 10.11210/tando1987.6.2_123

The incidence of gallstones after gastrectomy is 11.8%. The average interval between its onset and detection is relatively early,24 months. But the rate of spontaneous disappearancee is high,34.8%. In cases with total gastrectomy in resection procedure, Roux-en-Y and nonphysiological reconstruction, and lymphadenctomy at a degree of R2 or greater reveals significantly higher incidence rates. There was a tendency toward a postoperative increase in the cholecystic area under fasting conditions. The study of the postopeative kinetics of intrinsic cholecystic conraction showed a rapid contraction and a relaxation in the early phase, reveals significantly hypotonic state. The kinetics of the CCK secretion after gastrectomy was characterrized by early transient hypersecretion in response. In conclusion, the important facters involved in the pathogenesis of gallstones after gastrectomy were a reduction of cholecystic contractility and hypotonic state of gallbladder due to vagotomy associated with lymphadenectomy and a reduction of sensitivity in gallbladder wall to the CCK.