胃切除与术后胆石症的关系探讨

Analysis of the relationship between the postgastrectomy cholelithiasis and gastrectomy

目的探讨胃切除术后发生胆石症的可能因素。方法对52例胃切除术后胆石症患者资料进行回顾性分析。结果胃切除术后胆石症发生率明显高于正常人，BillrothⅡ式胃次全切除术后胆石症发生率为35．5％，全胃切除及近端胃切除术分别为31．5％和13．5％，Billroth Ⅰ式胃次全切除术为10．3％，选择性迷走神经切断术为2．5％。结论Billroth Ⅱ式胃次全切除术和全胃切除术是发生术后胆石症的危险因素，发生机制与术后消化道重建、胆汁酸代谢紊乱有关。

Objective To explore the factors for the development of gallstones after gastrectomy. Methods 52 cases of patients with postgastrectomy, were retrospectively analyzed according to their diseases for gastrectomy and operation form. Results Incidence of gallstone in patients of postgastrectomy was higher than in general population. Among which, Billroth Ⅱ type of gastrectomy for carcinoma was the highest （ 35. 5 % ）, then the total gastrectomy （31.5%） and proximate gastrectomy（ 13.5% ）. Billroth Ⅰ type operation was 10. 3%. Incidence of gallstone in patients of selective vagotomy was lowest （2.5%）. Conclusion BiUroth Ⅱ type of gastrectomy and total gastrectomy were the risk factors of postgastrectomy cholelithiasis. The causes for gallstone formation after Billroth Ⅱ type of gastrectomy were the restitution of digestive canal and metabolic disorder of bile acid.