| Author/Editor | Horvat, Matjaž | |
| Title | Kontraktilnost žučnog mjehura u bolesnika s totalnom gastrektomijom i limfadenektomijom | |
| Type | monografija | |
| Place | Zagreb | |
| Publisher | Sveučilište, Medicinski fakultet | |
| Publication year | 2004 | |
| Volume | str. 81 | |
| Language | cro | |
| Abstract | Background. The kinetics of gallbladder is being influenced upon numerous neurological and humoral factors. The operative procedure for gastric cancer involves, besides removal of the organ; lymphadenectomy. Lymphadenectomy causes dissection of nerve fibers of hepatic plexus, which innervates gallbladder and extra hepatic biliary tract. Reconstruction after total gastrectomy excludes duodenum, which influences humoral part of gallbladder kinetics. The purpose of our study was to establish the influence of total gastrectomy with lymphadenectomy in patients with gastric cancer on the gallbladder kinetics. Based upon the evidence of changed gallbladder kinetics we could conclude that there is a greater possibility of gallstone formation and therefore a synchronous cholecystectomy would be justified. Respondents and methods. In the prospective study using ultrasound (US), we measured gallbladder volumes at patients, preparing for surgical procedure of total gastrectomy, before and after the operation. Each patient had a measurement done in the starving state and after stimulatory meal in three 10 minutes intervals before and after the operation. We tried to standardize the US procedure and the stimulatory meal. Comparing the numeric data from different samples from the same persons we used Student-t test paired the sample for means in the Excel as well as in the SPSS 100 program. We considered p values < 0, OS statistically significant. Results. 30 patients with total gastrectomy were included in the study (19 males, 11 females, average age 65,27 years in an interval from 50 to 77). 28 patients had histopathological diagnosis of adenocarinoma (21 with diffuse or mixed type and 7 with intestinal type after Lauren) and 2 patients had a histological diagnosis of Non Hodgkin lymphoma. In our group 27 patients out of 30 (90%) showed an enlarged gallbladder volume (166% on average) in the starving state after the operation (p<0,01). (Abstract truncated at 2000 characters) | |
| Descriptors | STOMACH NEOPLASMS GASTRECTOMY LYMPH NODE EXCISION GALLBLADDER GALLBLADDER EMPTYING PROSPECTIVE STUDIES |