[Postoperative changes in cholecystosonogram and gallbladder motor function following gastrectomy--a prospective...

In 48 gastrectomized patients, presence of gallstones (GS) and debris echoes (DBS) in the gallbladder were examined serially before and 1, 2 weeks, 1, 3, 6 and 12 months after operation. Fasting gallbladder area (FGBA) and maximal gallbladder contraction rate (MGCR) after caerulein injection (0.2 micrograms/kg i.m.) were measured ultrasonographically. GS developed in 7 (14.6%) of 48 patients. Within 1 month, DBS were visualized in 19 (45.2%) of 42 patients. However, in only 2 of these 19 patients, transition from DBS to GS was confirmed thereafter. No DBS were detected in 4 of 7 patients who developed GS. FGBA, measured postoperatively, increased significantly compared with preoperative value. MGCR decreased significantly compared with preoperative value in 1 month, but gradually recovered thereafter. Although 19 patients with DBS showed significant increase of FGBA and decrease of MGCR within 1 month compared with 23 patents without DBS, no discrepancies were observed between 7 patients with GS and 41 patients without GS, as to these postoperative changes of FGBA and MGCR. These findings suggest that enlargement and contractile dysfunction of gallbladder in early postgastrectomy periods, which are closely related to the formation of DBS, are not necessarily essential factors in the pathogenesis of postgastrectomy gallstones.