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腹腔镜联合胆道镜取石术后胆结石早期复发的危险因素:一项单中心前瞻性研究

Risk Factors for Early Recurrence of Gallstones in Patients Undergoing Laparoscopy Combined With Choledochoscopic Lithotomy: A Single-Center Prospective Study.

作者信息

Wang Bo, Huang Anhua, Jiang Min, Li Haidong, Bao Wenqing, Ding Kan, Jiang Zhaoyan, Zhao Gang, Hu Hai

机构信息

Center of Gallbladder Diseases, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.

出版信息

Front Surg. 2021 Nov 24;8:759390. doi: 10.3389/fsurg.2021.759390. eCollection 2021.

Abstract

For patients with gallstones, laparoscopy combined with choledochoscopic lithotomy is a therapeutic surgical option for preservation rather than the removal of the gallbladder. However, postoperative recurrence of gallstones is a key concern for both patients and surgeons. This prospective study was performed to investigate the risk factors for early postoperative recurrence of gallstones. The clinical data of 466 patients were collected. Each patient was followed up for up to 2 years. The first follow-up visit occurred 4 months after the operation, and a follow-up visit was carried out every 6 months thereafter. The main goal of each visit was to confirm the presence or absence of gallbladder stones. The factors associated with gallstone recurrence were analyzed by univariate analysis and Cox regression. In total, 466 eligible patients were included in the study, and 438 patients (180 men and 258 women) completed the 2-year postoperative follow-up. The follow-up rate was 94.0%. Recurrence of gallstones was detected in 5.71% (25/438) of the patients. Univariate analysis revealed five risk factors for the recurrence of gallstones. Multivariate Cox regression analysis showed that multiple gallstones, a gallbladder wall thickness of ≥4 mm, and a family history of gallbladder stones were the three predictive factors for postoperative recurrence of gallstones ( < 0.05). The overall 2-year recurrence rate of gallstones after the operation was 5.71%. Multiple gallstones, a gallbladder wall thickness of ≥4 mm, and a family history of gallstones were the three risk factors associated with early postoperative recurrence of gallstones.

摘要

对于胆结石患者,腹腔镜联合胆道镜取石术是一种保留胆囊而非切除胆囊的治疗性手术选择。然而,胆结石术后复发是患者和外科医生都关注的关键问题。本前瞻性研究旨在探讨胆结石术后早期复发的危险因素。收集了466例患者的临床资料。每位患者随访长达2年。首次随访在术后4个月进行,此后每6个月进行一次随访。每次随访的主要目的是确认有无胆囊结石。通过单因素分析和Cox回归分析与胆结石复发相关的因素。本研究共纳入466例符合条件的患者,438例患者(180例男性和258例女性)完成了术后2年的随访。随访率为94.0%。5.71%(25/438)的患者检测到胆结石复发。单因素分析揭示了胆结石复发的五个危险因素。多因素Cox回归分析表明,多发胆结石、胆囊壁厚度≥4mm和胆结石家族史是术后胆结石复发的三个预测因素(<0.05)。术后胆结石的总体2年复发率为5.71%。多发胆结石、胆囊壁厚度≥4mm和胆结石家族史是与胆结石术后早期复发相关的三个危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/671e/8651707/68bf92ec284b/fsurg-08-759390-g0001.jpg

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