Shabanzadeh Daniel Mønsted, Sørensen Lars Tue, Jørgensen Torben
Digestive Disease Center, Bispebjerg University Hospital, Bispebjerg Bakke 23, DK-2400, Copenhagen, Denmark.
Research Centre for Prevention and Health, Capital Region of Denmark, Copenhagen, Denmark.
J Gastrointest Surg. 2017 May;21(5):831-839. doi: 10.1007/s11605-016-3349-y. Epub 2017 Jan 12.
High rates of persistent symptoms are found following cholecystectomy in patients with gallstones. The aim of this population based cohort study was to determine which symptoms were associated with the development of clinical gallstone events in a population unaware of their gallstones.
Three random population samples from Copenhagen (N = 6037) were examined with ultrasound during 1982-1994. Participants were not informed about gallstone status. Abdominal symptoms were assessed at baseline through a questionnaire. Follow-up for clinical events was performed through central registers until 2011. Multivariable Cox regression analyses were performed.
Participants unaware of their gallstones (N = 595) were followed for median 17.5 years. A total of 16.6% participants developed clinical events. Both uncomplicated and complicated events were associated with high pain intensity at baseline. Complicated events were also associated with pain at night. Uncomplicated events were associated with pain localized in the epigastrium, of longer duration, and in need of pain medication. No associations were identified for dyspepsia or irritable bowel syndrome.
In a population of unaware gallstone carriers, it was possible to identify abdominal symptoms associated with later clinical detection of the gallstones. These finding may contribute to a better selection of patients for surgery.
胆结石患者胆囊切除术后持续症状发生率较高。这项基于人群的队列研究旨在确定在未意识到自己有胆结石的人群中，哪些症状与临床胆结石事件的发生有关。
1982年至1994年期间，对来自哥本哈根的三个随机人群样本（N = 6037）进行了超声检查。参与者未被告知胆结石状况。通过问卷调查在基线时评估腹部症状。通过中央登记处对临床事件进行随访至2011年。进行多变量Cox回归分析。
未意识到自己有胆结石的参与者（N = 595）中位随访17.5年。共有16.6%的参与者发生了临床事件。单纯性和复杂性事件均与基线时的高疼痛强度相关。复杂性事件还与夜间疼痛有关。单纯性事件与上腹部疼痛、持续时间较长且需要使用止痛药物有关。未发现与消化不良或肠易激综合征有关联。
在未意识到自己有胆结石的人群中，有可能识别出与后来临床发现胆结石相关的腹部症状。这些发现可能有助于更好地选择手术患者。
