Kim W H, Lee K J, Yoo B M, Kim J H, Kim M W
Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
Hepatogastroenterology. 2000 Mar-Apr;47(32):343-5.
BACKGROUND/AIMS: Pancreatitis is a serious complication of patients with gallstones. However, risk factors of gallstone pancreatitis were unpredictable until recently. In Korea, characteristics of gallstones are different from Western countries. The present study was designed to determine differences in the risk of gallstone pancreatitis and characteristics of gallstones in Korean patients.
Clinical data were collected on patients undergoing laparoscopic cholecystectomy. The physical characteristics of gallstones recovered at surgery were also recorded. Patients with gallstone pancreatitis were compared with patients who had uncomplicated biliary pain.
In a logistic regression model, acute gallstone pancreatitis was associated with a stone diameter of less than 5 mm (odds ratio: 3.3695; P = 0.0352) and with stone number of more than 20 (odds ratio: 3.8686; P = 0.0361). No other variable, including pigment stone, age, and sex, remained statistically significant in the adjusted analysis (P > 0.05).
Patients with at least 1 gallstone smaller than 5 mm in diameter and stone number more than 20 each have a more than 3-fold increased risk of presenting with acute gallstone pancreatitis. The composition of gallstones, especially pigment stones, was not an important risk factor in gallstone pancreatitis in Korean patients with stones having a different composition than those from Western countries.
背景/目的:胰腺炎是胆结石患者的一种严重并发症。然而,直到最近胆结石性胰腺炎的危险因素仍无法预测。在韩国,胆结石的特征与西方国家不同。本研究旨在确定韩国患者胆结石性胰腺炎风险及胆结石特征的差异。
收集接受腹腔镜胆囊切除术患者的临床数据。还记录了手术中取出的胆结石的物理特征。将胆结石性胰腺炎患者与无并发症胆绞痛患者进行比较。
在逻辑回归模型中,急性胆结石性胰腺炎与直径小于5mm的结石(比值比:3.3695;P = 0.0352)及结石数量超过20颗(比值比:3.8686;P = 0.0361)相关。在调整分析中,包括色素结石、年龄和性别在内的其他变量均无统计学意义(P>0.05)。
直径至少有1颗小于5mm且结石数量超过20颗的患者发生急性胆结石性胰腺炎的风险增加3倍以上。在结石成分与西方国家不同的韩国患者中,胆结石的成分,尤其是色素结石,并非胆结石性胰腺炎的重要危险因素。