Litiaza veziculară consecutivă rezectiilor gastrice

Abstract

Introducere. Majoor si Suren (1947) au atras primii atenția asupra apariției litiazei biliare dupa intervețtiile chirurgicale pe stomac, inclunzând-o printre complicațiile acestora.Material si Metode. Experiența noastră privind litiaza biliara dupa interventii chirurgicale pentru ulcer gastroduodenal se bazeaza pe analiza unui lot de 1611 pacienti operati pentru colecistita acuta sau cronica litiazica, in ultimii 15 ani (1996- 2010 ). Dintre acestea 34 (2,1%) prezentau biliopatii ca consecinta a stomacului operat. Varsta bolnavilor a fost cuprinsa în limitele 32 – 76 ani.Barbati / femei- 55 / 45 % . In mod programat s-au internat 20 pacienti (58,8%) si 14 (41,2%) urgent (colecistita acuta). Operatiile efectuate in antecedente : rezectii gastrice Billroth I – 20 pacienti (58,8%), Billroth II – 9 pacienti (26,5%) . Excezia ulcerului cu vagotomie tronculara 5 (14,7%) pacienti. Rezultate. Intervalul dintre operatia gastrica si aparitia calculilor biliari este urmatorul : de la 1 – 3 ani – 13 pacienti (38,2%) , 3- 5 ani 5 pacienti (14,7%), 5-10 ani 6 pacienti (17,6%), mai mult de zece ani 10 pacienti ( 29,4%). Concluzii. Rezumand aceasta expunere putem semnala semnificatia interventiei chirurgicale gastrice în aparitia litiazei biliare dupa rezectie gastrica generata de staza duodenala functionala in ansa proximala după rezectia gastrica Billroth II, si ca urmare a dischineziei gastro-duodenale si veziculare după rezectia gastrica Billroth I sau vagotomia. Rezumand aceasta expunere putem semnala semnificatia interventiei chirurgicale gastrice în aparitia litiazei biliare

Introduction. Major and Suren (1947) first drew attention to the appearance of gallstones after surgery on the stomach, including it among their complications. Material and methods. Our experience on gallstone after surgery for gastro duodenal ulcer is based on analysis of a group of 1611 patients operated for acute or chronic cholecystitis lithiasis, in the last 15 years (1996- 2010. 34 (2.1%) of these had gallstones disease as a consequence of stomach surgery. The age of patients was within the limits of 32 – 76 years. Male/female –55/ 45%. Programmatically were hospitalized 20 patients (58,8%) and (41,2%) urgent (acute cholecystitis). History of operation performed: gastric resection Billroth I – 20 patients (58,8%), Billroth II – 9 patients (26,5%). Ulcer excision with truncal vagotomy 5 (14,7%) patients.Results. The interval of gastric surgery and the occurrence of gallstone is following: from 1- 3 years – 13 patients ( 38,2%), 3- 5 years 5 patients (14,7%), 5-10 years 6 patients (17,6%) more then ten years 10 patients (29,4%). Conclusions. Summarizing this exposure we can indicate the significance of gastric surgery in occurrence of gallstone after gastric resection caused by functional duodenal stasis in the proximal loop after gastric resection Billroth II and as a result of gastro-duodenal and gallbladder dyskinesia after the gastric resection Billroth I or vagotomy.