BACKGROUND/AIMS: The aim of this study was to investigate the epidemiological characteristics and changing patterns of gallstone disease over the last 20 years. METHODS: Four thousands and twenty gallstone patients who had received surgery at Seoul National University Hospital (1981~2000) were analyzed according to time of treatment; period I: 1981~1985 (831 cases), period II: 1986~1990 (888 cases), period III: 1991~1995 (1,040 cases) and period IV: 1996~ 2000 (1,261 cases). Data from 13 institutes in Korea reporting 13,101 gallstone cases were also reviewed with literature to elucidate the nation-wide trends. RESULTS: The number of gallstone cases has gradually increased. A female- predominance was not observed (F/M=1.17-1.37). The CBD stone patients were older than the GB and the IHD stone patients. Over the study period, the relative portion of the GB stone group increased. The portion of CBD stone group decreased, while that of the IHD stone group was unchanged. The rural pattern of gallstone disease (low GB stone, high CBD and IHD stone) has become similar to the urban pattern. Such patterns are well agreed with the other literature reported in Korea. CONCLUSIONS: The pattern of gallstone disease in Korea has become similar to that in Western countries except a high prevalence of hepatolithiasis.
Cholelithiasis/epidemiology/*surgery ; Female ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Prevalence

Laparoscopic mini-gastric bypass surgery is a safe and simple surgical intervention for treating morbid obesity and diabetes mellitus and is now being performed more frequently. Radiologists must be critical in their postoperative evaluation of these patients. In this pictorial review, we explain and illustrate the surgical technique, normal postoperative anatomy, and associated complications as seen on imaging examinations, including fluoroscopy and computed tomography.
Adult ; Anastomotic Leak/epidemiology ; Cholelithiasis/epidemiology ; Constriction, Pathologic/epidemiology ; Diabetes Mellitus/*therapy ; Female ; Fluoroscopy ; Gastric Bypass/*methods ; Hemorrhage/epidemiology ; Humans ; Laparoscopy ; Male ; Middle Aged ; Obesity, Morbid/*surgery ; Stomach/radiography/surgery ; Tomography, X-Ray Computed

BACKGROUND/AIMS: The well-organized study to support that increased cholelithiasis and bile duct dilatation can occur after gastrectomy has not been reported. The aim of this study was to determine the incidence of cholelithiasis and the degree of common bile duct (CBD) dilatation in patients undergoing subtotal gastrectomy, compared to those undergoing endoscopic treatment for gastric cancer. METHODS: Patients who diagnosed with gastric cancer and received treatment at six academic referral centers were investigated for the incidence and time of cholelithiasis and the degree of CBD dilatation after treatment by analysis of 5-year follow-up CTs. The operation group underwent subtotal gastrectomy without vagotomy, while in the control group endoscopic treatment was administered for gastric cancer. RESULTS: A total of 802 patients were enrolled in 5-year analysis (735 patients in the operation group and 67 patients in the control group). Cholelithiasis occurred in 47 patients (6.39%) in the operation group and 3 patients (4.48%) in the control group (p=0.7909). The incidences of cholelithiasis were 4.28% in Billoth-I and 7.89% in Billoth-II (p=0.0487). The diameter of proximal CBD and distal CBD increased by 1.11 mm and 1.41 mm, respectively, in the operation group, compared to 0.4 mm and 0.38 mm, respectively, in the control group (p<0.05). Patients with increased CBD dilatation more than 5 mm showed statistically significant increases in alkaline phosphatase and gamma-glutamyltransferase. CONCLUSIONS: The incidence of cholelithiasis was not increased due to subtotal gastrectomy without vagotomy, but the incidence was higher after Billoth-II compared to Billoth-I. In addition, significant change in the CBD diameter was observed after subtotal gastrectomy.
Aged ; Alanine Transaminase/analysis ; Aspartate Aminotransferases/analysis ; Bilirubin/analysis ; Case-Control Studies ; Cholelithiasis/*diagnosis/epidemiology ; Common Bile Duct/diagnostic imaging/*physiopathology ; Endoscopy, Gastrointestinal ; Female ; Follow-Up Studies ; Gastrectomy ; Humans ; Incidence ; Male ; Middle Aged ; Odds Ratio ; Stomach Neoplasms/*surgery ; Tertiary Care Centers ; Tomography, X-Ray Computed