Tuula Tyrväinen1, Isto Nordback1, Jyri Toikka2, Anneli Piiroinen3, Karl-Heinz Herzig4, Kari Mäkelä4, Juhani Sand1. 1. a Department of Gastroenterology and Alimentary Tract Surgery , Tampere University Hospital , Tampere , Finland. 2. b Department of Clinical Physiology , Tampere University Hospital , Tampere , Finland. 3. c Department of Clinical Radiology , Tampere University Hospital , Tampere , Finland. 4. d Institute of Biomedicine and Biocenter of Oulu, University of Oulu, Medical Research Center Oulu and Oulu University Hospital , Oulu , Finland.
Abstract
BACKGROUND AND AIMS: The incidence of gallstones and gallbladder sludge is higher in patients after total gastrectomy than in general population. Formation of gallstones after gastrectomy is multifactorial. Here, we investigate the changes in gallbladder and biliary tract functions by cholescintygraphy and monitored changes in cholecystokinin (CCK) release in long-term survivors after total gastrectomy for gastric carcinoma. MATERIAL AND METHODS: Patients had undergone total gastrectomy for gastric carcinoma at least five years ago. The final study population consisted of 25 patients. RESULTS: Eight patients had undergone cholecystectomy before or at the time of gastrectomy. Gallstone formation was observed in seven of the remaining 17 patients during follow-up (41%). Maximum uptake of radioactivity and gallbladder maximum uptake was significantly delayed in the gastrectomy group than in the control group. There was no significant difference in CCK levels after the overnight fasting and at 60 minutes after stimulation among patients with or without stones in situ compared with healthy volunteers, but 30 minutes after the energy-rich drink patients had higher CCK levels than the control group. CONCLUSIONS: In gastrectomy patients, technetium isotope visualisation of the gallbladder and time for maximum activity was significantly delayed. This may indicate impaired gallbladder function. On the contrary, CCK release was not impaired.
BACKGROUND AND AIMS: The incidence of gallstones and gallbladder sludge is higher in patients after total gastrectomy than in general population. Formation of gallstones after gastrectomy is multifactorial. Here, we investigate the changes in gallbladder and biliary tract functions by cholescintygraphy and monitored changes in cholecystokinin (CCK) release in long-term survivors after total gastrectomy for gastric carcinoma. MATERIAL AND METHODS:Patients had undergone total gastrectomy for gastric carcinoma at least five years ago. The final study population consisted of 25 patients. RESULTS: Eight patients had undergone cholecystectomy before or at the time of gastrectomy. Gallstone formation was observed in seven of the remaining 17 patients during follow-up (41%). Maximum uptake of radioactivity and gallbladder maximum uptake was significantly delayed in the gastrectomy group than in the control group. There was no significant difference in CCK levels after the overnight fasting and at 60 minutes after stimulation among patients with or without stones in situ compared with healthy volunteers, but 30 minutes after the energy-rich drink patients had higher CCK levels than the control group. CONCLUSIONS: In gastrectomy patients, technetium isotope visualisation of the gallbladder and time for maximum activity was significantly delayed. This may indicate impaired gallbladder function. On the contrary, CCK release was not impaired.
Entities:
Keywords:
Total gastrectomy; cholecystokinin; cholescintygraphy; gallstones
Authors: Zhi Zheng; Weitao Zhang; Chenglin Xin; Na Zeng; Mengyi Li; Xiaoye Liu; Jun Cai; Fandong Meng; Dong Liu; Jie Zhang; Jie Yin; Jun Zhang; Zhongtao Zhang Journal: Ann Transl Med Date: 2021-06