Abstract
To clarify the etiology of cholelithiasis following gastrectomy for gastric cancer, we examined bile flow by 99mTC-N-pyridoxyl-5-methyltryptophan hepatobiliary scintigraph. Four parameters were obtained: peak time of the right lobe of the liver, peak time of the left lobe of the liver, peak time of the common bile duct, and time of RI appearance in the duodenum. These parameters were determined in 22 patients who had undergone gastrectomy with R2 lymph-node dissection and cholecystectomy as treatment for gastric cancer (gastrectomy group), and 28 control patients who had undergone cholecystectomy for cholecystolithiasis or cholesterol polyps of the gallbladder. Every parameter was higher in the gastrectomy group than in the cholecystectomy group. In the gastrectom group, the diameter of the common bile duct was correlated with the parameters obtained by hepatobiliary scintigraphy. These findings suggest that gastrectomy with lymph-node dissection causes delay of bile flow, contributing to the etiology of cholelithiasis following gastrectomy for gastric cancer. Moreover, the result that the diameter of the common bile duct was correlated with the delay of bile flow suggests that denervation due to lymph-node dissection might cause dysfunction of the sphincter of Oddi and the delay of bile flow.
