Analysis of the factors influencing the recurrence of gallbladder stones after minimally invasive choledocholithotomy
ZHU Kai-feng，CHEN Yun，ZHAN Wei-hua
Department of Gastroenterology, Tongde Hospital of Zhejiang Province，Hangzhou (310012), China
Abstract:
Objective To understand the situation of stone recurrence after gallbladecolithotomy, analyze the factors affecting stone recurrence and evaluate the feasibility of gallbladecolithotomy. Methods A total of 171 patients who received gallbladder-preserving cholecystolithotomy in our hospital from December 2019 to October 2021 were collected and followed up for 1 year. They were divided into recurrence group (13 cases) and non-recurrence group (158 cases). The gender, age, family history, hypertension, diabetes, BMI, stone number, gallbladder wall hairiness, triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and administration of Chinese medicine were compared between two groups, and the related factors of stone recurrence were analyzed. Results The one-year postoperative recurrence rate of the patients was 7.6%(13/171). Univariate analysis showed that the number of stones, gallbladder wall roughness, TG, HDL-C, family history and taking Chinese medicine had statistical significances (P<0.05). Multivariate Logistic regression analysis showed that Cystic stone quantity > 1 (OR=11.585, 95% CI=1.578-85.030, P=0.016), TG (OR=4.139, 95% CI=1.402-12.220, P=0.010), family history (OR=8.785, 95% CI=1.238-62.345, P=0.030) are independent risk factors for stone recurrence after gallbladder-preserving cholecystolithotomy (P<0.05). Taking traditional Chinese medicine (OR=0.059, 95%CI=0.008-0.433, P=0.005) can reduce the recurrence rate of stone. Conclusion The number of gallstones, TG and family history are independent risk factors for stone recurrence after gallbladder-preserving cholecystolithotomy. Taking Paishi decoction can reduce the risk of recurrence. Patients with risk factors should be cautious in gallbladder-preserving cholecystolithotomy, or preventive treatment should be conducted for risk factors after surgery.
