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肝切除术后胆结石发病率增加的危险因素分析:一项回顾性病例对照研究。

Analysis of risk factors for the increased incidence of gallstone caused by hepatectomy: A retrospective case-control study.

作者信息

Zhou Jiangmin, Chen Lin, Zhang Zhiwei, Wu Biao

机构信息

Department of Hepatobiliary Surgery, Wuhan No.1 Hospital (Wuhan Hospital of Traditional Chinese and Western Medicine), Wuhan, China.

Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Front Surg. 2023 Mar 1;10:1097327. doi: 10.3389/fsurg.2023.1097327. eCollection 2023.

Abstract

BACKGROUND

An increased risk of gallstones has been observed in patients undergoing hepatectomy. This study attempted to analyze the risk factors for gallstones after hepatectomy.

METHODS

From January 2013 to December 2016, clinical data of 1,452 eligible patients who underwent hepatectomy were consecutively reviewed. According to the imaging, including gallbladder ultrasound, computerized tomography, and magnetic resonance imaging, all patients were divided into the gallstone group and the nongallstone group. Univariate and multivariate logistic regression analyses were performed to select indicators associated with gallstone formation among patients after hepatectomy.

RESULTS

In the total sample of included patients, there were 341 patients with gallstones and 1,147 patients without gallstones. The incidence of gallstones was 23.5% (341/1,452). The incidence of gallstones in the primary liver cancer group was higher than that in the benign liver tumor group (25.7% vs. 18.9%,  = 0.004). Univariate and multivariate logistic regression analyses showed that female gender, high body mass index, tumor located in S5, and severe postoperative complication were factors related to gallstones in patients with benign liver tumors after hepatectomy. In addition, Child-Pugh B, low albumin, liver cirrhosis, and transcatheter arterial chemoembolization (TACE) after recurrence were factors related to gallstones in patients with primary liver cancer after hepatectomy.

CONCLUSIONS

Hepatectomy increased the risk of gallstones in benign or malignant liver tumors, especially when the tumor was located in S5. TACE further increased the risk of gallstones in patients with postoperative recurrence.

摘要

背景

肝切除术后患者胆结石风险增加。本研究旨在分析肝切除术后胆结石的危险因素。

方法

回顾性分析2013年1月至2016年12月期间连续接受肝切除术的1452例符合条件患者的临床资料。根据胆囊超声、计算机断层扫描和磁共振成像等影像学检查结果,将所有患者分为胆结石组和非胆结石组。采用单因素和多因素逻辑回归分析,筛选肝切除术后患者胆结石形成的相关指标。

结果

在纳入患者的总样本中,有341例患者患有胆结石,1147例患者无胆结石。胆结石发生率为23.5%(341/1452)。原发性肝癌组胆结石发生率高于良性肝肿瘤组(25.7%对18.9%,P = 0.004)。单因素和多因素逻辑回归分析显示,女性、高体重指数、肿瘤位于S5以及严重术后并发症是肝切除术后良性肝肿瘤患者胆结石的相关因素。此外,Child-Pugh B级、低白蛋白、肝硬化以及复发后经动脉化疗栓塞(TACE)是肝切除术后原发性肝癌患者胆结石的相关因素。

结论

肝切除术增加了良性或恶性肝肿瘤患者胆结石的风险,尤其是当肿瘤位于S5时。TACE进一步增加了术后复发患者胆结石的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f810/10014528/b67e0059a68e/fsurg-10-1097327-g001.jpg

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