Less invasive treatments of symptomatic biriary tract stones after gastrectomy

Abstract

The incidence of biliary tract stones after gastrectomy has been widely reported to be high, about 15%. In this study the treatments of post-gastrectomy biliary tract stones were retrospectively examined because laparoscopic cholecystectomy for gallstones and endoscopic bile duct lithotomy have become standard therapeutic options. We enrolled 2978 cases operated on for gallstones and 2627 cases of gastrectomy from 1992 to 2007.
Symptomatic biliary tract stones were complicated in 2% (53 patients) of post-gastrectomy patients. The rate of bile duct stones in post-gastrectomy patients was higher than that in non-gastrectomy patients. Laparoscopic cholecystectomy for gallstones was feasible. Endoscopic bile duct lithotomy followed by laparoscopic cholecystectomy was considered to be good therapeutic option in the patients in whom endoscopic bile duct intervention could be performed. On the other hand, choledochoenterostomy might be another option in the patients in whom endoscopic bile duct intervention could not be performed.