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首页> 外文期刊>Surgical Endoscopy >Risk factors for cholecystectomy in patients with gallbladder stones after endoscopic clearance of common bile duct stones.
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Risk factors for cholecystectomy in patients with gallbladder stones after endoscopic clearance of common bile duct stones.

机译：内镜清除胆总管结石后胆囊结石患者胆囊切除术的危险因素。

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摘要

BACKGROUND: Cholecystectomy usually is recommended for patients with gallbladder (GB) stones who previously underwent endoscopic removal of common bile duct (CBD) stones. However, in practice, many patients still have GB stones after improvement of their biliary symptoms. This study aimed to evaluate risk factors for cholecystectomy in patients with GB stones after complete endoscopic clearance of CBD stones. METHODS: From August 2003 to April 2006, the medical data of 61 patients with concomitant GB stones who underwent complete endoscopic clearance of CBD stones were reviewed retrospectively. The risk factors for subsequent cholecystectomy were evaluated during a 24-month of follow-up period. RESULTS: Among the 61 patients, 12 (19.7%) subsequently required cholecystectomy for recurrence of biliary symptoms, and 11 of these 12 patients (91.7%) needed cholecystectomy within 12 months. Gallbladder stones 10 mm or larger (p = 0.037) and the acute pancreatitis (p = 0.049) were the independent risk factors for subsequent cholecystectomy. The actuarial probability of remaining free of subsequent cholecystectomy during the follow-up period was higher for the patients with GB stones smaller than 10 mm than for the patients with GB stones 10 mm or larger (86.7% vs. 62.5%; p = 0.037). In addition, the patients with acute pancreatitis had a higher tendency for subsequent cholecystectomy than the patients without acute pancreatitis (50% vs. 16.4%; p = 0.078). CONCLUSIONS: Only a small number of patients subsequently needed to undergo cholecystectomy for recurrence of biliary symptoms, and most events developed within 12 months. For the patients with GB stones 10 mm or larger or acute pancreatitis, prophylactic cholecystectomy is strongly recommended after complete clearance of CBD stones.
机译：背景：通常建议对胆囊结石（GB）结石的患者进行胆囊切除术，这些患者先前曾接受内镜下胆总管结石的切除术。但是，实际上，许多患者的胆汁症状改善后仍会出现GB结石。本研究旨在评估内镜清除CBD结石后GB结石患者进行胆囊切除术的危险因素。方法：回顾性分析2003年8月至2006年4月行内镜完全清除CBD结石的61例伴有GB结石的患者的医学资料。在随访的24个月中评估了随后进行胆囊切除术的危险因素。结果：61例患者中，有12例（19.7％）随后因胆道症状的复发而需要进行胆囊切除术，而这12例患者中的11例（91.7％）在12个月内需要进行胆囊切除术。 10毫米或更大的胆囊结石（p = 0.037）和急性胰腺炎（p = 0.049）是随后进行胆囊切除术的独立危险因素。 GB小于10 mm的患者比随访10 mm或更大的GB结石的患者在随访期间没有继续进行胆囊切除术的精算几率更高（86.7％vs. 62.5％; p = 0.037） 。此外，与没有急性胰腺炎的患者相比，患有急性胰腺炎的患者随后进行胆囊切除术的可能性更高（50％vs. 16.4％; p = 0.078）。结论：随后只有少数患者因胆道症状的复发而需要进行胆囊切除术，大多数事件在12个月内发生。对于GB结石10 mm或更大或急性胰腺炎的患者，强烈建议在完全清除CBD结石后进行预防性胆囊切除术。

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