症状性胆结石病:复发模式和第一次入院后复发的风险因素,RELAPSTONE研究
Raúl Velamazán1,2,3, Pablo López-Guillén4,5, Samuel J Martínez-Domínguez1,3
1Department of Gastroenterology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.
United European gastroenterology journal
|February 20, 2024
概括
对于胆结石疾病而言,延迟胆囊切除导致高复发率. 诸如年龄和多种结石等因素影响复发风险,有助于优先考虑胆囊切除术患者.
科学领域:
- 胃肠病学 胃肠病学
- 外科手术的结果
- 流行病学 流行病学
背景情况:
- 在有症状的胆结石病患者中,延迟胆囊切除 (胆囊切除) 与疾病复发有关.
- 关于胆结石复发模式及其预测因素的数据有限.
研究的目的:
- 调查不同症状胆结石病呈现的复发模式.
- 在等待胆囊切除术的患者中确定与胆结石疾病复发相关的因素.
主要方法:
- 一项回顾性国际多中心队列研究 (RELAPSTONE) 涉及3016名患有第一次症状胆结石发作的患者.
- 患者在最初的入院期间没有接受胆囊切除术.
- 使用卡普兰-梅尔曲线和多变量考克斯回归模型分析了无复发生存率.
主要成果:
- 在3,6和12个月的无复发生存率分别为79%,71%和63%.
- 年龄较大,先前的缩切除术和较高的白细胞数量与复发风险较低有关.
- 氨酸氨基转移酶水平升高和多次胆结石与复发率增加相关.
结论:
- 症状性胆结石疾病的复发率显著且因具体情况而异.
- 识别出复发的独立预测因素可以告知患者优先考虑及时胆囊切除术.
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