A risk factor of gallstone formation after radical gastrectomy

The incidence of gallstones is higher in patients after radical gastrectomy than in the general population. The current literature suggests that this higher incidence is related to gallbladder motility disorder after surgery. A research group in China investigated the association between the XbaI polymorphisms of APOB gene and gallstone formation after gastrectomy. Patient with the X+ allele of APOB gene was found to be another important risk factor of gallstone formation after radical gastrectomy.

The cause of higher incidence of gallstone after radical gastrectomy still remains unknown. Almost all previous studies have attributed gallstone formation to gallbladder motility disorder after gastrectomy, But this theory cannot completely explain it. Is there any other risk factor of gallstone formation after gastrectomy?

A research article to be published on May 28, 2010 in the World Journal of Gastroenterology addresses this question. The research team led by Professor Niu from Zhongshan Hospital of Fudan University enrolled 206 patients between January 2005 and December 2006, who underwent radical gastrectomy for gastric cancer. These patients were grouped according to XbaI polymorphisms of APOB gene.

After at least 2 years follow up, they found that the incidence of gallstone following gastrectomy was significiantly higher in patients with the X+ allele of APOB gene, who have a higher concentration of TC and LDL. These results demonstrate that the X+ allele may influence the levels of TC and LDL, resulting in an increased saturation of bile cholesterol, leading to the gallstone formation after gastrectomy. The authors believe besides the gallbladder motility disorder, X+ allele of APOB gene is another important risk factor of gallstone formation after gastrectomy.