근치적 위아전 절제술 후 재건 방식에 따른 담낭 운동성의 변화에 대한 전향적인 연구
Effect of Reconstruction-Method after a Radical Subtotal Gastrectomy on Gallbladder Motility
허윤석, 김장용, 허민희, 안승익, 홍기천, 신석환, 우제홍, 최원식,
소속 상세정보
허윤석 ( Heo Yoon-Seok )
인하대학교 의과대학 일반외과학교실
김장용 ( Kim Jang-Yong )
인하대학교 의과대학 일반외과학교실
허민희 ( Hur Min-Hee )
인하대학교 의과대학 일반외과학교실
안승익 ( Ahn Seung-Ik )
인하대학교 의과대학 일반외과학교실
홍기천 ( Hong Kee-Chun )
인하대학교 의과대학 일반외과학교실
신석환 ( Shin Seok-Hwan )
인하대학교 의과대학 일반외과학교실
우제홍 ( Woo Ze-Hong )
인하대학교 의과대학 일반외과학교실
최원식 ( Choi Won-Sick )
인하대학교 의과대학 핵의학과교실
KMID : 0371320010600040451
Abstract
Purpose: An increased incidence of gallstones has been widely reported in patients who had undergone a gastrectomy. But, there has been little information about the pathophysiologic mechanism for the occurrence of gallstones after gastric surgery. Many investigators have considered the cause to be decreased gallbladder motility due to vagal denervation. We observed higher increase in the incidence of gallbladder stones in patients who underwent a Billroth II gastrojejunostomy than in those who underwent a Billroth I gastrojejunostomy after radical subtotal gastrectomy.
Methods: We prospectively studied the change in the motility of the gallbladder after a gastrectomy. The gallbladder ejection fraction (EF) was compared pre- and postoperatively by using gallbladder scintigraphy with 2,6-diisopropyl-iminodiacetic acid (DISIDA).
Results: Twenty patients underwent a Billroth(B) I anastomosis and twelve patients underwent a B-II anastmosis after the gastrectomy. The means of the EF of the B-I group were 75.9%, 46.4%, 68.1% at the preoperative period, at 1 month and 6 months after the gastrectomy respectively. Those of B-II group were 78.2%, 45.3%, 56.3%, respectively. There was no statistically significant difference of EF between the two groups at postoperative 1 month, but the difference at postoperative 6months was statistically significant. The differences of EF between preoperative period and postoperative 1 month, 6 months were significant in the B-I group and the B-II group.
Conclusion: At 6 months postoperative period, there was more recovered gallbladder motility after a gastrectomy with B-I anastomosis than with B-II anastomosis.
키워드
위 절제술;담석증;장관운동
Gallbladder motility;Gastrectomy;Gallbaldder ejection fraction;Gallstone
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