|
1
|
Song J, Park SJ, Park JJ, Kim TI, Park J, Cheon JH. Prevalence and risk factors for gallstone and renal stone formation in patients with intestinal Behçet's disease. Korean J Intern Med 2024; 39:770-782. [PMID: 39135522 PMCID: PMC11384251 DOI: 10.3904/kjim.2024.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 03/25/2024] [Accepted: 04/08/2024] [Indexed: 09/11/2024] Open
Abstract
BACKGROUND/AIMS The association between inflammatory bowel disease (IBD) and gallstone and renal stone formation has been established. However, few studies have investigated this association in patients with intestinal Behçet's disease (BD). We aimed to examine the prevalence of gallstones and renal stones in patients with intestinal BD and identify potential risk factors. METHODS We analyzed gallstone and renal stone occurrences in 553 patients diagnosed with intestinal BD who had undergone cross-sectional imaging examinations between March 2005 and April 2021 at the IBD Center, Severance Hospital, Seoul, South Korea. Logistic regression models were used to identify risk factors for gallstone and renal stone formation. RESULTS Of 553 patients over a mean 12.1-year duration, 141 (25.4%) patients had gallstones and 35 (6.3%) had renal stones. In multivariate logistic regression analysis, disease duration > 19 years (OR 2.91, 95% CI 1.56-5.44, 0.002). No significant correlation 0.001), prior intestinal BD-related surgery (OR 2.29, 95% CI 1.42-3.68, p < 0.001), and disease activity index for intestinal BD scores ≥ 75 (OR 2.23, 95% CI 1.12-4.45, p = 0.022) were associated with increased gallstone occurrence. A positive correlation was observed between renal stones, disease duration > 19 years (OR 5.61, 95% CI 1.98-15.90, p = 0.001) and frequent hospitalization (> 3 times) (OR 3.29, 95% CI 1.52-7.13, p = 0.002). No significant correlation was observed between gallstone and renal stone occurrence. CONCLUSION These findings contribute to greater understanding concerning gallstone and renal stone prevalence and associated risk factors in patients with intestinal BD.
Collapse
Affiliation(s)
- Jaewon Song
- Department of Internal Medicine, Institute of Gastroenterology, Severance Hospital, Yonsei University College of Medicine, Seoul,
Korea
| | - Soo Jung Park
- Department of Internal Medicine, Institute of Gastroenterology, Severance Hospital, Yonsei University College of Medicine, Seoul,
Korea
- Center of Inflammatory Bowel Disease, Severance Hospital, Yonsei University College of Medicine, Seoul,
Korea
| | - Jae Jun Park
- Department of Internal Medicine, Institute of Gastroenterology, Severance Hospital, Yonsei University College of Medicine, Seoul,
Korea
- Center of Inflammatory Bowel Disease, Severance Hospital, Yonsei University College of Medicine, Seoul,
Korea
| | - Tae Il Kim
- Department of Internal Medicine, Institute of Gastroenterology, Severance Hospital, Yonsei University College of Medicine, Seoul,
Korea
- Center of Inflammatory Bowel Disease, Severance Hospital, Yonsei University College of Medicine, Seoul,
Korea
| | - Jihye Park
- Department of Internal Medicine, Institute of Gastroenterology, Severance Hospital, Yonsei University College of Medicine, Seoul,
Korea
- Center of Inflammatory Bowel Disease, Severance Hospital, Yonsei University College of Medicine, Seoul,
Korea
| | - Jae Hee Cheon
- Department of Internal Medicine, Institute of Gastroenterology, Severance Hospital, Yonsei University College of Medicine, Seoul,
Korea
- Center of Inflammatory Bowel Disease, Severance Hospital, Yonsei University College of Medicine, Seoul,
Korea
- Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul,
Korea
| |
Collapse
|
|
2
|
Stamate E, Piraianu AI, Duca OM, Ciobotaru OR, Fulga A, Fulga I, Onisor C, Matei MN, Luchian AS, Dumitrascu AG, Ciobotaru OC. The Effect of Increased Intra-Abdominal Pressure on Hemodynamics in Laparoscopic Cholecystectomy-The Experience of a Single Centre. J Pers Med 2024; 14:871. [PMID: 39202062 PMCID: PMC11355812 DOI: 10.3390/jpm14080871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2024] [Revised: 07/15/2024] [Accepted: 08/15/2024] [Indexed: 09/03/2024] Open
Abstract
Laparoscopic cholecystectomy is characterized by reduced postoperative pain, shorter hospital stays, rapid return to preoperative physical activity, and less psychological impact on the patient. During laparoscopic cholecystectomy, the intra-abdominal insufflation of carbon dioxide with secondary increase in intra-abdominal pressure can cause important hemodynamic consequences, like decreased cardiac output and blood pressure, as well as compensatory increase in heart rate. The purpose of this study is to evaluate changes in cardiovascular parameters during general anesthesia in patients undergoing laparoscopic cholecystectomy. Retrospective data from 342 patients with cholecystectomy for cholelithiasis performed at Railway Hospital Galati, Romania, were reviewed. All patients received the same intraoperative anesthetics. Female patients were 85.7% (n = 293). More than half of the patients, 53.51% (n = 183), were 40-59 years old, and only 16.37% (n = 56) were under 40 years old. Patients with a normal body mass index (BMI) represented 45.6% (n = 156), 33.3% (n = 114) were underweight, and 12% (n = 42) had grade 1 obesity (BMI 25-29.9 kg/m2). The minimum intraoperative blood pressure correlated with patient gender (p 0.015 < 0.005), with men having a higher blood pressure than women (p 0.006 < 0.05), and for BMI, a higher BMI was associated with elevated blood pressure (p 0.025 < 0.05). Older age correlated with an increased maximum intraoperative blood pressure (p < 0.001 < 0.05) and with maximum intraoperative heart rate (p 0.015 < 0.05). Patients undergoing laparoscopic cholecystectomy experienced significant hemodynamic changes with pneumoperitoneum, but this type of surgical intervention was safe for patients regardless of their age.
Collapse
Affiliation(s)
- Elena Stamate
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 35, Al. I. Cuza Street, 800216 Galati, Romania; (E.S.); (C.O.)
| | - Alin-Ionut Piraianu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 35, Al. I. Cuza Street, 800216 Galati, Romania; (E.S.); (C.O.)
| | - Oana-Monica Duca
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 35, Al. I. Cuza Street, 800216 Galati, Romania; (E.S.); (C.O.)
| | - Oana Roxana Ciobotaru
- Department of Clinical Medical, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 35, Al. I. Cuza Street, 800216 Galati, Romania;
| | - Ana Fulga
- Department of Clinical Surgical, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 35, Al. I. Cuza Street, 800216 Galati, Romania; (A.F.); (O.C.C.)
| | - Iuliu Fulga
- Department of Medical, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 35, Al. I. Cuza Street, 800216 Galati, Romania;
| | - Cristian Onisor
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 35, Al. I. Cuza Street, 800216 Galati, Romania; (E.S.); (C.O.)
| | - Madalina Nicoleta Matei
- Department of Dental Medicine, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 35, Al. I. Cuza Street, 800216 Galati, Romania;
| | | | - Adrian George Dumitrascu
- Division of Hospital Internal Medicine, Department of Medicine, Mayo Clinic Florida, 4500 San Pablo Rd S, Jacksonville, FL 32224, USA;
| | - Octavian Catalin Ciobotaru
- Department of Clinical Surgical, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 35, Al. I. Cuza Street, 800216 Galati, Romania; (A.F.); (O.C.C.)
| |
Collapse
|
|
3
|
Chen LT, Vogel A, Hsu C, Chen MH, Fang W, Pangarsa EA, Sharma A, Ikeda M, Park JO, Tan CK, Regala E, Tai D, Tanasanvimon S, Charoentum C, Chee CE, Lui A, Sow J, Oh DY, Ueno M, Ramaswamy A, Jeo WS, Zhou J, Curigliano G, Yoshino T, Bai LY, Pentheroudakis G, Chiang NJ, Cervantes A, Chen JS, Ducreux M. Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with biliary tract cancer. ESMO Open 2024; 9:103647. [PMID: 39232586 PMCID: PMC11410730 DOI: 10.1016/j.esmoop.2024.103647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 06/17/2024] [Accepted: 06/19/2024] [Indexed: 09/06/2024] Open
Abstract
The European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with biliary tract cancer (BTC), published in late 2022 were adapted in December 2023, according to established standard methodology, to produce the Pan-Asian adapted (PAGA) ESMO consensus guidelines for the management of Asian patients with BTC. The adapted guidelines presented in this manuscript represent the consensus opinions reached by a panel of Asian experts in the treatment of patients with BTC representing the oncological societies of China (CSCO), Indonesia (ISHMO), India (ISMPO), Japan (JSMO), Korea (KSMO), Malaysia (MOS), the Philippines (PSMO), Singapore (SSO), Taiwan (TOS) and Thailand (TSCO), co-ordinated by ESMO and the Taiwan Oncology Society (TOS). The voting was based on scientific evidence and was independent of the current treatment practices, drug access restrictions and reimbursement decisions in the different regions of Asia. Drug access and reimbursement in the different regions of Asia are discussed separately in the manuscript. The aim is to provide guidance for the optimisation and harmonisation of the management of patients with BTC across the different countries and regions of Asia, drawing on the evidence provided by both Western and Asian trials, whilst respecting the differences in screening practices and molecular profiling, as well as age and stage at presentation. Attention is drawn to the disparity in the drug approvals and reimbursement strategies, between the different countries.
Collapse
Affiliation(s)
- L-T Chen
- Kaohsiung Medical University Hospital, Center for Cancer Research, Kaohsiung Medical University, Kaohsiung; National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan.
| | - A Vogel
- Department of Gastroenterology, Hepatology and Endocrinology, Medical School of Hannover, Hannover, Germany; Division of Gastroenterology and Hepatology, Toronto General Hospital, Medical Oncology, Princess Margaret Cancer Centre, Toronto, Canada
| | - C Hsu
- Department of Oncology, National Taiwan University Hospital, Taipei; Department of Medical Oncology, National Taiwan University Cancer Center, Taipei
| | - M-H Chen
- Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - W Fang
- Department of Medical Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - E A Pangarsa
- Haematology Medical Oncology Division, Department of Oncology, Faculty of Medicine, Diponegoro University/Dr. Kariadi Hospital, Semarang, Indonesia
| | - A Sharma
- Department of Medical Oncology, Max Institute of Cancer Care, Max Super Specialty Hospital, Saket, New Delhi, India
| | - M Ikeda
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - J O Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - C K Tan
- Department of Oncology and Nuclear Medicine, Thomson Hospital Kota Damansara, Petaling Jaya, Selangor, Malaysia
| | - E Regala
- Clinical Division Building, University of Santo Tomas Hospital, Sampaloc, Manila, Philippines
| | - D Tai
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - S Tanasanvimon
- Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok
| | - C Charoentum
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - C E Chee
- Department of Haematology-Oncology, National University Cancer Institute, National University Health System, Singapore, Singapore
| | - A Lui
- Department of Internal Medicine, Metro Davao Medical and Research Center, Davao City; Section of Medical Oncology, Department of Internal Medicine, Southern Philippines Medical Center, Davao City, The Philippines
| | - J Sow
- Department of Oncology, Curie Oncology Kuala Lumpur, Kuala Lumpur, Malaysia
| | - D-Y Oh
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - M Ueno
- Department of Gastroenterology, Kanagawa Cancer Center, Yokohama, Japan
| | - A Ramaswamy
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, India
| | - W S Jeo
- Division of Digestive Surgery, Department of General Surgery, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - J Zhou
- Department of Gastrointestinal Oncology, Peking University Cancer Hospital & Institute, Beijing, China
| | - G Curigliano
- Istituto Europeo di Oncologia, Milano, IRCCS, Milano; Department of Oncology and Haematology, University of Milano, Milano, Italy
| | - T Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - L-Y Bai
- Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | | | - N-J Chiang
- Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - A Cervantes
- Department of Medical Oncology, INCLIVA Biomedical Research Institute, University of Valencia, Valencia; CIBERONC. Instituto de Salud Carlos III, Madrid, Spain
| | - J-S Chen
- Department of Internal Medicine, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | - M Ducreux
- INSERM U1279, Université Paris-Saclay, Villejuif; Department of Cancer Medicine, Gustave Roussy, Villejuif, France
| |
Collapse
|
|
4
|
Mahdi RA, Naseeb AT, Almoataz MW, Hubail DR, Alsaffar YS. Biliary Disease in a Tertiary Care Hospital: A Review of Clinical and Radiological Burden. Cureus 2024; 16:e52927. [PMID: 38406075 PMCID: PMC10893906 DOI: 10.7759/cureus.52927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 02/27/2024] Open
Abstract
Introduction Gallbladder disease accounts for a significant percentage of surgical admissions per year. A review of these cases was done to assess their hospital impact with an evaluation of the efficacy of radiological modalities in terms of evaluation, ideal use, and clinical application. Therefore, this study aims to review the demographics of the disease, the diagnostic yield of radiological modalities, and the overall outcome in regards to the hospital policies and medical services provided in hopes of achieving suitable clinical pathways, increasing the efficiency of gallbladder disease assessment, and limiting unwarranted investigations. Methods This is a single-center, retrospective study that included all the surgical emergency admissions from January 1st to December 31st 2018, in the Salmaniya Medical Complex, Kingdom of Bahrain. A total sample of 163 emergency admissions (cases) was selected from those aged 14 and older with documented biliary stones or biliary-related disease. A review of radiological modalities for diagnosis included plain radiographs (AXR, CXR), US abdomen, CT scans, and MRCP/MRI, which were then correlated with histopathological findings confirming the presence of gallstone disease. In addition to evaluating readmissions and emergency visits in terms of hospital burden. Results One hundred and sixty-three (10.44%) of 1,562 surgical admission cases in 2018 were diagnosed with biliary tree disease (76 males, 87 females). A total of 419 different radiological investigations were requested in 161 of the cases evaluated: 53.7% of plain radiographs (AXR, CXR), 33.2% of US abdomen, 11.9% of CT scan, and 1.2% of MRCP/MRI. Ultrasound showed a sensitivity of 48.72% and a specificity of 100%, while CT scan sensitivity was 57.14% and a specificity of 100% when it came to detecting gallstones and gallbladder-related disease. Plain radiographs add no direct benefit to diagnosing biliary disease. Conclusion Gallbladder disease is very prevalent with a wide array of disease entities, requiring radiological assistance in diagnosis. Ultrasound is the ideal modality for the diagnosis of biliary disease due to its ease of use and availability; it has high sensitivity and specificity, and it can be complemented by other modalities such as CT scans and MRCP/MRI when it comes to assessing for complications. On the other hand, plain radiographs have no significant value in the detection of gallbladder-related disease, and their utilization should be limited to emergency cases with high clinical suspicion.
Collapse
Affiliation(s)
- Rawan A Mahdi
- General Practice, Royal College of Surgeons in Ireland-Bahrain, Manama, BHR
| | - Ali T Naseeb
- Internal Medicine, Salmaniya Medical Complex, Manama, BHR
| | | | | | | |
Collapse
|
|
5
|
Cha B, Lee J, Lee J, Park JS, Jeong S, Lee DH. Clinical correlation of cholelithiasis in patients undergoing percutaneous endoscopic gastrostomy. Sci Rep 2023; 13:22039. [PMID: 38086971 PMCID: PMC10716124 DOI: 10.1038/s41598-023-49417-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 12/07/2023] [Indexed: 12/18/2023] Open
Abstract
The risk factor for cholelithiasis include low physical activity. With an aging society, the number of bedridden patients who undergo percutaneous endoscopic gastrostomy (PEG) has increased, and cholelithiasis has often been found in these patients. This study aimed to evaluate the risk factors correlated with cholelithiasis in adults who underwent PEG. This retrospective single-center design study reviewed patients who underwent PEG and were confirmed to have cholelithiasis through imaging from March 1996 to December 2021. The investigated variables were age, sex, body mass index (BMI, kg/m2), cause of PEG insertion, initial physical activity status, laboratory findings on PEG insertion day, and incidence of acute cholecystitis. The differences between categorical and continuous variables were analyzed using Student's t test and chi-square test. We enrolled 576 eligible patients who underwent PEG insertion. A total of 161 patients were detected with cholelithiasis (28.0%). The overall independent risk factors for cholelithiasis in patients who underwent PEG insertion were increased C-reactive protein (CRP) levels and decreased physical activity status (bedridden state). The incidence of cholelithiasis was increased by up to 30.7%, especially in patients with bedridden status. However, the incidence of acute cholecystitis among cholelithiasis group was only 5.6%. BMI and total cholesterol were positively correlated with the size of gallbladder (GB) stones. One of the major risk factors for cholelithiasis is decreased physical activity, especially in patients who underwent PEG insertion. Abdominal imaging is recommended to confirm the presence of cholelithiasis and to consider prophylaxis for cholelithiasis, especially in bedridden patients with elevated initial CRP levels at the time of PEG insertion.
Collapse
Grants
- NRF-2022R1F1A1067621 the National Research Foundation of Korea (NRF) grant funded by the Korea government
- (Project Number: 9991006975, KMDF_PR_20200901_0155) the Korea Medical Device Development Fund grant funded by the Korean government (the Ministry of Science and ICT, Ministry of Trade, Industry and Energy, Ministry of Health & Welfare, and the Ministry of Food and Drug Safety)
- (NTIS, KMDF-RnD 202016B01) the Korea Medical Device Development Fund grant funded by the Korean government (the Ministry of Science and ICT, Ministry of Trade, Industry and Energy, Ministry of Health & Welfare, and the Ministry of Food and Drug Safety)
Collapse
Affiliation(s)
- Boram Cha
- Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea
| | - Jungnam Lee
- Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea
| | - Jaehyuk Lee
- Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea
| | - Jin-Seok Park
- Department of Internal Medicine, Shihwa medical center, Siheung, Republic of Korea.
| | - Seok Jeong
- Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea
| | - Don Haeng Lee
- Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea
| |
Collapse
|
|
6
|
Khan I, Yadav P, Saran RK, Sharma S, Sharma AK. A Study of the Degree of Gall Bladder Wall Thickness and Its Impact on Patients Undergoing Laparoscopic Cholecystectomy. Cureus 2023; 15:e38990. [PMID: 37323346 PMCID: PMC10261991 DOI: 10.7759/cureus.38990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2023] [Indexed: 06/17/2023] Open
Abstract
Background The gold standard management for symptomatic gallstone disease is elective laparoscopic cholecystectomy, which has replaced open cholecystectomy. The wall thickness of the gallbladder is an indicator of cholecystitis in patients who have presented with symptoms of gallstone disease. The aim of this study was to evaluate preoperative gall bladder wall thickness by ultrasonography and assess its impact on the outcome of laparoscopic cholecystectomy, including conversion rate, complications, operative time, and postoperative hospital stay. Method This prospective study was conducted on 350 patients with symptomatic gallstone disease, those who had undergone laparoscopic cholecystectomy in Dr. Sampurnanand Medical College, Jodhpur, and attached hospitals from July 2019 to November 2021. On the basis of ultrasonography findings of gallbladder wall thickness, patients were divided into four groups: normal thickness - up to 2 mm, mild thickness - 3-4mm, moderate thickness - 5-6mm, and severe wall thickness - more than 6mm). Up to 2 millimeters thickness was considered as normal. Results The incidence of conversion rate, as well as intra or postoperative complications, were higher in moderate and severe wall thickness groups. The maximum incidence of complication rate is seen in moderately thickened group (33.33%). In severely thickened group, complication was seen in 100% of patients. Operative time, as well as postoperative hospital stay, were more in higher thickness groups. There was a statistically significant correlation between gallbladder wall thickness and conversion rate, complications operative time, and postoperative length of stay. Conclusion Increased gallbladder wall thickness causes increased intra as well as postoperative complications, more conversion to open procedure rate, increased operative time, and enhanced postoperative hospital stay. Among the total study population, 29.71% of patients had increased gallbladder wall thickness. In our study, a positive correlation was seen among gallbladder wall thickness, complication rate, conversion rate, intraoperative time, and postoperative hospital stay.
Collapse
Affiliation(s)
- Irshad Khan
- General Surgery, Dr. Sampurnanand Medical College, Jodhpur, IND
| | - Parul Yadav
- General Surgery, Dr. Sampurnanand Medical College, Jodhpur, IND
| | - Rama K Saran
- General Surgery, Dr. Sampurnanand Medical College, Jodhpur, IND
| | - Sarthak Sharma
- General Surgery, Dr. Sampurnanand Medical College, Jodhpur, IND
| | - Amit K Sharma
- General Surgery, Dr. Sampurnanand Medical College, Jodhpur, IND
| |
Collapse
|
|
7
|
Tehrani AN, Saadati S, Yari Z, Salehpour A, Sadeghi A, Daftari G, Ghorbani M, Hekmatdoost A. Dietary fiber intake and risk of gallstone: a case-control study. BMC Gastroenterol 2023; 23:119. [PMID: 37041462 PMCID: PMC10091554 DOI: 10.1186/s12876-023-02752-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 03/29/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND Gallstone disease (GSD) and its complications are major public health issues globally. Although many community-based studies had addressed the risk factors for GSD, little is known about the associations between dietary factors and risk of disease. The present study aimed to investigate the potential associations between dietary fibers with the risk of gallstone disease. METHODS In this case-control study, 189 GSD patients with less than one month of diagnosis and 342 age‑matched controls were enrolled. Dietary intakes were assessed using a 168-item semi-quantitative validated food frequency questionnaire. Crude and multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated through cox proportional hazards regression models. RESULTS Comparing the highest versus the lowest tertile, significant reverse associations were observed between odds of GSD and each category of dietary fiber intake including total (OR T3 vs. T1 = 0.44, 95% CI: 0.37-0.7, P for trend = 0.015), soluble (OR T3 vs. T1 = 0.51, 95% CI: 0.3-0.8, P for trend = 0.048) and insoluble (OR T3 vs. T1 = 0.56, 95% CI: 0.3-0.9, P for trend < 0.001). The relationship between dietary fiber intake and the risk of gallstones was more prominent in overweight and obese subjects than in subjects with a normal body mass index. CONCLUSION Comprehensive assessment of the associations of dietary fiber intake with GSD showed that higher intakes of dietary fiber were significantly associated with reduced GSD risk.
Collapse
Affiliation(s)
- Asal Neshatbini Tehrani
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Saeede Saadati
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Zahra Yari
- Department of Nutrition Research, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences Tehran, West Arghavan St. Farahzadi Blvd., Sharake Qods, Tehran, Iran.
| | - Amin Salehpour
- School of Public Health, Occupational Health Research Center, Iran Universityof Medical Sciences, Tehran, Iran
| | - Amir Sadeghi
- Research Institute for Gastroenterology and Liver Diseases of Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ghazal Daftari
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Moloud Ghorbani
- Department of Community Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Azita Hekmatdoost
- Clinical Nutrition and Dietetics Department, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences Tehran, Tehran, Iran
| |
Collapse
|
|
8
|
Kwon MJ, Lee JW, Kang HS, Lim H, Kim ES, Kim NY, Choi HG, Kim MJ. Association between Gallstone Disease and Statin Use: A Nested Case-Control Study in Korea. Pharmaceuticals (Basel) 2023; 16:ph16040536. [PMID: 37111293 PMCID: PMC10143191 DOI: 10.3390/ph16040536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/25/2023] [Accepted: 03/31/2023] [Indexed: 04/29/2023] Open
Abstract
The correlation between statin use and the development of gallstone disease remains controversial. Existing data, primarily based on Caucasian populations, are biased, thus necessitating validation studies involving Asian cohorts. We conducted a nested case-control study using data from the Korean National Health Insurance Service Health Screening Cohort (2002-2019) to determine the likelihood of gallstone disease according to periods of previous statin use and type of statin. Among the 514,866 participants, 22,636 diagnosed with gallstones at ≥2 clinic visits (using the International Classification of Diseases, 10th revision, code K80) were matched 1:4 to 90,544 controls for age, sex, income, and residential area, and their statin prescription history for 2 years prior to the index date was examined. Propensity-score-weighted odds ratios (ORs) for gallstone disease were calculated using conditional logistic regression. Long-term use (>545 days) of any statin or lipophilic statins was associated with lower odds of incident gallstones (OR = 0.91, 95% confidence interval [CI] = 0.86-0.96, p < 0.001 and OR = 0.88, 95% CI = 0.83-0.93, p < 0.001, respectively) after adjusting for confounders. Short-term use (180-545 days) of any statin or hydrophilic statins was not statistically related to incident gallstones. In summary, prior statin medication, particularly long-term lipophilic statin use, may confer a preventive advantage against gallstone disease.
Collapse
Affiliation(s)
- Mi Jung Kwon
- Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Jung Woo Lee
- Department of Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Ho Suk Kang
- Division of Gastroenterology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Hyun Lim
- Division of Gastroenterology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Eun Soo Kim
- Department of Radiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| | - Nan Young Kim
- Hallym Institute of Translational Genomics and Bioinformatics, Hallym University Medical Center, Anyang 14068, Republic of Korea
| | - Hyo Geun Choi
- Suseo Seoul ENT Clinic and MD Analytics, 10, Bamgogae-ro 1-gil, Gangnam-gu, Seoul 06349, Republic of Korea
| | - Min-Jeong Kim
- Department of Radiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea
| |
Collapse
|
|
9
|
Dupont B, Dejardin O, Bouvier V, Piquet MA, Alves A. Systematic Review: Impact of Social Determinants of Health on the Management and Prognosis of Gallstone Disease. Health Equity 2022; 6:819-835. [PMID: 36338799 PMCID: PMC9629913 DOI: 10.1089/heq.2022.0063] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2022] [Indexed: 11/06/2022] Open
Abstract
Background: Due to its prevalence, gallstone disease is a major public health issue. It affects diverse patient populations across various socioeconomic levels. Socioeconomic and geographic deprivation may impact both morbidity and mortality associated with digestive diseases, such as biliary tract disease. Aim: The aim of this systematic review was to review the available data on the impact of socioeconomic determinants and geographic factors on gallstone disease and its complications. Methods: This systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The MEDLINE and Web of Science databases were searched by two investigators to retrieve studies about the impact of income, insurance status, hospital status, education level, living areas, and deprivation indices on gallstone disease. Thirty-seven studies were selected for this review. Results: Socially disadvantaged populations appear to be more frequently affected by complicated or severe forms of gallstone disease. The prognosis of biliary tract disease is poor in these populations regardless of patient status, and increased morbidity and mortality were observed for acute cholangitis or subsequent cholecystectomy. Limited or delayed access and low-quality therapeutic interventions could be among the potential causes for this poor prognosis. Conclusions: This systematic review suggests that socioeconomic determinants impact the management of gallstone disease. Enhanced knowledge of these parameters could contribute to improved public health policies to manage these diseases.
Collapse
Affiliation(s)
- Benoît Dupont
- Departement d'Hepato-Gastroenterologie et Nutrition, UNICAEN, CHU de Caen Normandie, Normandie Univ, Caen, France
- “Anticipe” U1086 INSERM-UCBN, “Cancers & Preventions,” Team Labelled “League Against Cancer,” UNICAEN, Normandie Univ, CAEN, France
| | - Olivier Dejardin
- “Anticipe” U1086 INSERM-UCBN, “Cancers & Preventions,” Team Labelled “League Against Cancer,” UNICAEN, Normandie Univ, CAEN, France
- Registre des Tumeurs Digestives du Calvados, “Anticipe” U1086 INSERM-UCBN, UNICAEN, Normandie Univ, Caen, France
| | - Véronique Bouvier
- “Anticipe” U1086 INSERM-UCBN, “Cancers & Preventions,” Team Labelled “League Against Cancer,” UNICAEN, Normandie Univ, CAEN, France
- Registre des Tumeurs Digestives du Calvados, “Anticipe” U1086 INSERM-UCBN, UNICAEN, Normandie Univ, Caen, France
| | - Marie-Astrid Piquet
- Departement d'Hepato-Gastroenterologie et Nutrition, UNICAEN, CHU de Caen Normandie, Normandie Univ, Caen, France
| | - Arnaud Alves
- “Anticipe” U1086 INSERM-UCBN, “Cancers & Preventions,” Team Labelled “League Against Cancer,” UNICAEN, Normandie Univ, CAEN, France
- Service de Chirurgie Digestive, UNICAEN, CHU de Caen Normandie, Normandie Univ, Caen, France
| |
Collapse
|
|
10
|
Jeon CH, Hong J, Jung J, Moon JY, Seo HS. Chronological trends in patients undergoing cholecystectomy in Korea: a nationwide health insurance claims study. Ann Surg Treat Res 2022; 102:205-213. [PMID: 35475231 PMCID: PMC9010967 DOI: 10.4174/astr.2022.102.4.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 02/10/2022] [Accepted: 03/08/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose The incidence of gallstone disease and cholecystectomy is increasing worldwide. The aim of this study was to determine trends in the incidence of cholecystectomy in Korea. Methods The National Health Insurance Services database was used to determine patterns in proportion of cholecystectomy and cholecystostomy in the total population of Korea from 2003 to 2017. The age-standardized rate (ASR) was calculated to compare the cholecystectomy and cholecystostomy according to changes in the population structure over time. The ASR was investigated according to patient age, sex, socioeconomic status, use of computed tomography, and type of hospital to identify trends. Results The ASR per 100,000 based on the 2010 population of cholecystectomy cases increased markedly from 67.7 to 211.4 between 2003 and 2017. The ASR was consistently higher in female than male (71.9 vs. 63.6 in 2003, 221.8 vs. 201.8 in 2017). Furthermore, the ASR for cholecystectomy increased with age, and surgery for gallstone disease was performed more often at a specialized center than at other medical facilities. The length of hospital stay of cholecystectomy decreased steadily from 10.6 days in 2003 to 6.9 days in 2017. Conclusion This study shows that the incidence of cholecystectomy and cholecystostomy has steadily increased over the years in Korea, with a trend toward older age and higher socioeconomic status in patients undergoing cholecystectomy. Increasing use of computed tomography investigations could be a primary cause for this trend. An integrated strategy is needed to manage the increase in older patients undergoing cholecystectomy and shorten their hospital stay with medical safety.
Collapse
Affiliation(s)
- Chul Hyo Jeon
- Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jinwook Hong
- Artificial Intelligence and Big-Data Convergence Center, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Jaehun Jung
- Artificial Intelligence and Big-Data Convergence Center, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Korea
| | - Jong Youn Moon
- Artificial Intelligence and Big-Data Convergence Center, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Korea
- Center for Public Healthcare, Gachon University Gil Medical Center, Incheon, Korea
| | - Ho Seok Seo
- Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| |
Collapse
|
|
11
|
Zang L, Zhang Y, Zhao J, Yuan Y, Wen Y, Lian J, Chen S, Chen Y, Liu W, Niu Z, Wang X, Peng C, Zhang W, Meng Z, Lu J. A metabolomics study of Qianliexin capsule treatment of benign prostatic hyperplasia induced by testosterone propionate in the rat model. Anal Biochem 2021; 628:114258. [PMID: 34081927 DOI: 10.1016/j.ab.2021.114258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/30/2021] [Accepted: 05/15/2021] [Indexed: 11/16/2022]
Abstract
A metabolomics investigation of the treatment effect of Qianliexin (QLX) capsules was conducted on rats with benign prostatic hyperplasia (BPH) induced by testosterone propionate. Establishment of the BPH model was confirmed using the prostatic index. Hematoxylin and eosin (HE) staining for TGF-β, EGFR, collagen, IL-1 β, TNF-α was performed and changes in urine volume were measured. Urine and serum samples were collected from three groups, including a control group, a BPH model group and a QLX-treated group and subjected to metabolomics profiling based on ultrahigh-performance liquid chromatography-mass spectrometry. Pharmacodynamics analysis showed that the QLX group had significantly lower histopathological damage, fibrosis damage, and inflammation and higher urine output compared with the model group. Twenty-two potential biomarkers were identified in urine samples and 23 metabolites were identified in plasma samples. Alterations in metabolic patterns were evident in all sample types. The treatment effects of QLX appear to involve various metabolic pathways including lipid metabolism, fatty acid metabolism and purine generation and significantly reduced the pathological symptoms and related biochemical indicators of BPH and improved the level of potential marker metabolites. This comprehensive study suggested that differential markers provided insights into the metabolic pathways involved in BPH and the treatment effects of QLX.
Collapse
Affiliation(s)
- Linghe Zang
- Institute of Life Science and Bio-pharmaceuticals, Pharmaceutical College, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, 110016, Liaoning Province, China
| | - Yuwei Zhang
- Institute of Traditional Chinese Medicine, Shandong Hongjitang Pharmaceutical Group Co., Ltd., Jinan, 250103, Shandong Province, China
| | - Jing Zhao
- Institute of Life Science and Bio-pharmaceuticals, Pharmaceutical College, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, 110016, Liaoning Province, China
| | - Yunxia Yuan
- Institute of Life Science and Bio-pharmaceuticals, Pharmaceutical College, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, 110016, Liaoning Province, China
| | - Yi Wen
- Institute of Life Science and Bio-pharmaceuticals, Pharmaceutical College, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, 110016, Liaoning Province, China
| | - Jiaxin Lian
- Institute of Life Science and Bio-pharmaceuticals, Pharmaceutical College, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, 110016, Liaoning Province, China
| | - Shuailong Chen
- Institute of Life Science and Bio-pharmaceuticals, Pharmaceutical College, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, 110016, Liaoning Province, China
| | - Yiran Chen
- Institute of Life Science and Bio-pharmaceuticals, Pharmaceutical College, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, 110016, Liaoning Province, China
| | - Weiyi Liu
- Institute of Life Science and Bio-pharmaceuticals, Pharmaceutical College, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, 110016, Liaoning Province, China
| | - Ze Niu
- Institute of Life Science and Bio-pharmaceuticals, Pharmaceutical College, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, 110016, Liaoning Province, China
| | - Xinyue Wang
- Institute of Life Science and Bio-pharmaceuticals, Pharmaceutical College, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, 110016, Liaoning Province, China
| | - Chunlin Peng
- Institute of Life Science and Bio-pharmaceuticals, Pharmaceutical College, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, 110016, Liaoning Province, China
| | - Wenxin Zhang
- Institute of Life Science and Bio-pharmaceuticals, Pharmaceutical College, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, 110016, Liaoning Province, China
| | - Zhaoqing Meng
- Institute of Traditional Chinese Medicine, Shandong Hongjitang Pharmaceutical Group Co., Ltd., Jinan, 250103, Shandong Province, China.
| | - Jincai Lu
- Institute of Life Science and Bio-pharmaceuticals, Pharmaceutical College, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, 110016, Liaoning Province, China.
| |
Collapse
|
|
12
|
Zhang Z, Li Y, Li K, Zhai G, Dang X, Zhong C, Shi Z, Zou R, Wang L, Wei D, Tang B, Ge J. Value of multidisciplinary team (MDT) in minimally invasive treatment of complex intrahepatic bile duct stones. Biosci Trends 2021; 15:161-170. [PMID: 34078766 DOI: 10.5582/bst.2021.01169] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This study aimed to investigate the value of multidisciplinary team (MDT) management in minimally invasive treatment of complex intrahepatic bile duct stones (IHDs) by laparoscopy, choledochoscopy and percutaneous choledochoscopy. The characteristics, perioperative index, complication rate and minimally invasive rate of patients in MDT group (n = 75) and non-MDT group (n = 70) were compared. The members of MDT include doctors in ultrasound, imaging, hepatobiliary and pancreatic surgery, anaesthesia and intensive care medicine. The results showed that minimally invasive surgery reduced the incidence of postoperative residual stones, OR (95% CI) = 0.365 (0.141-0.940) (p = 0.037). MDT reduced the operation time, OR (95% CI) = 0.406 (0.207-0.796) (p = 0.009). Minimally invasive surgery significantly reduced intraoperative bleeding, OR (95% CI) = 0.267 (0.133-0.534) (p < 0.001). Minimally invasive surgery also reduced hospitalization time, OR (95% CI) = 0.295 (0.142-0.611) (p = 0.001). The stone clearance rates of MDT group and non-MDT group were 81.33% and 81.43% respectively. In the MDT group, the operative time was less than that in the non-MDT group (p = 0.010); the intraoperative bleeding volume was significantly less than that in the non-MDT group (p < 0.001); the hospitalization time was less than that in the non-MDT group (p = 0.001). Minimally invasive operation rate:48 cases (64.00%) in MDT group were significantly higher than 17 cases (24.29%) in non-MDT group (p < 0.001). In conclusion, minimally invasive procedures can be selected more through MDT. MDT can shorten the operation time, and minimally invasive surgery can reduce the incidence of residual stones, reduce intraoperative bleeding, and may shorten hospital stay. Therefore, MDT management model can provide personalized and minimally invasive surgical protocol for patients with complex IHD, which has high application value.
Collapse
Affiliation(s)
- Zhihong Zhang
- Department of Hepatobiliary and Pancreatic Surgery, Second Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China
| | - Yanyang Li
- Department of Hepatobiliary and Pancreatic Surgery, Second Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China
| | - Kejia Li
- Department of Hepatobiliary and Pancreatic Surgery, Second Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China
| | - Guang Zhai
- Department of Hepatobiliary and Pancreatic Surgery, Second Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China
| | - Xueyuan Dang
- Department of Hepatobiliary and Pancreatic Surgery, Second Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China
| | - Chao Zhong
- Department of Hepatobiliary and Pancreatic Surgery, Second Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China
| | - Zhitian Shi
- Department of Hepatobiliary and Pancreatic Surgery, Second Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China
| | - Renchao Zou
- Department of Hepatobiliary and Pancreatic Surgery, Second Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China
| | - Lin Wang
- Department of Hepatobiliary and Pancreatic Surgery, Second Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China
| | - Dong Wei
- Department of Hepatobiliary and Pancreatic Surgery, Second Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China
| | - Bo Tang
- Department of Hepatobiliary and Pancreatic Surgery, Second Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China
| | - Jiayun Ge
- Department of Hepatobiliary and Pancreatic Surgery, Second Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China
| |
Collapse
|
|
13
|
Gallstone Frequency in Patients with Helicobacter pylori Gastritis. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2021. [DOI: 10.5812/archcid.100805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Identification of the causes of gallstone would result in better planning for the prevention of this disease. One of the proposed risk factors for this problem is Helicobacter pylori (H. pylori) infection. Objectives: The purpose of this study was to determine the incidence rate of gallstone in patients with H. pylori gastritis. Methods: This was an observational study performed as a descriptive-comparative cross-sectional survey. We enrolled 169 consecutive patients with H. pylori gastritis admitted to Imam-Hossein Hospital, Tehran, Iran, in 2018, and gallstone frequency in them was determined and compared with other variables. Results: Overall, 14 (8.3%) patients had gallstone, and all the patients had H. pylori gastritis. There was no significant association between gallstone and H. pylori gastritis (P = 0.561). Conclusions: It may be concluded that gallstone frequency in patients with H. pylori gastritis is low, and there is no significant association between these two conditions.
Collapse
|
|
14
|
Huang D, Lee J, Song N, Cho S, Choe S, Shin A. Gallstones, Cholecystectomy and the Risk of Hepatobiliary and Pancreatic Cancer: A Nationwide Population-based Cohort Study in Korea. J Cancer Prev 2020; 25:164-172. [PMID: 33033710 PMCID: PMC7523037 DOI: 10.15430/jcp.2020.25.3.164] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 09/21/2020] [Accepted: 09/21/2020] [Indexed: 11/03/2022] Open
Abstract
Several epidemiological studies suggest a potential association between gallstones or cholecystectomy and hepatobiliary and pancreatic cancers (HBPCs). The aim of this study was to evaluate the risk of HBPCs in patients with gallstones or patients who underwent cholecystectomy in the Korean population. A retrospective cohort was constructed using the National Health Insurance Service-National Sample Cohort (NHIS-NSC). Gallstones and cholecystectomy were defined by diagnosis and procedure codes and treated as time-varying covariates. Hazard ratios (HRs) in relation to the risk of HBPCs were estimated by Cox proportional hazard models. Among the 704,437 individuals who were included in the final analysis, the gallstone prevalence was 2.4%, and 1.4% of individuals underwent cholecystectomy. Between 2002 and 2015, 487 and 189 individuals developed HBPCs in the gallstone and cholecystectomy groups, respectively. A significant association was observed between gallstones and all HBPCs (HR 2.16; 95% CI 1.92-2.42) and cholecystectomy and all HBPCs (HR 2.03; 95% CI 1.72-2.39). However, when 1-, 3-, and 5-year lag periods were applied, the HBPC and subsites risk approached zero. A significant association was observed between cholecystectomy and intrahepatic bile duct cancer (IBDC) (HR 2.68; 95% CI 1.63-4.40). When 1-, 3- and 5-year lag periods were applied, the IBDC risk after cholecystectomy was 2.86-fold (95% CI 1.68-4.85), 2.92-fold (95% CI 1.51-5.64), and 4.08-fold (95% CI 1.94-8.61) higher, respectively, than that in the comparison group. In conclusion, gallstone diagnosis and cholecystectomy seem to correlate with HBPCs, especially cholecystectomy and IBDC.
Collapse
Affiliation(s)
- Dan Huang
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.,Division of Cancer Control and Policy, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Joonki Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.,Division of Cancer Control and Policy, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Nan Song
- Cancer Research Institute, Seoul National University, Seoul, Korea.,Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Sooyoung Cho
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sunho Choe
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Aesun Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.,Cancer Research Institute, Seoul National University, Seoul, Korea
| |
Collapse
|
|
15
|
Lee YJ, Park YS, Park JH. Cholecystectomy is Feasible in Children with Small-Sized or Large Numbers of Gallstones and in Those with Persistent Symptoms Despite Medical Treatment. Pediatr Gastroenterol Hepatol Nutr 2020; 23:430-438. [PMID: 32953638 PMCID: PMC7481062 DOI: 10.5223/pghn.2020.23.5.430] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 05/01/2020] [Indexed: 12/21/2022] Open
Abstract
PURPOSE We investigated the clinical features and factors affecting the choice of treatment modality and the course of pediatric gallstone (GS) disease. METHODS We retrospectively analyzed the medical records of 65 patients diagnosed with GS using imaging studies between January 2009 and December 2017 were included. RESULTS This study included 65 patients (33 boys and 32 girls; mean age, 8.5±5.3 years; range, 0.2-18 years) who primarily presented with abdominal pain (34%), jaundice (18%), and vomiting (8%). Idiopathic GS occurred in 36 patients (55.4%). The risk factors for GS included antibiotic use, obesity, hemolytic disease, and chemotherapy in 8 (12.3%), 7 (10.8%), 6 (9.2%), and 4 patients (6.2%), respectively. We observed multiple stones (including sandy stones) in 31 patients (47.7%), a single stone in 17 (26.2%), and several stones in 17 (26.2%). GS with a diameter of <5 mm occurred in 45 patients (69.2%). Comorbidities included hepatitis, choledocholithiasis, cholecystitis, and acute pancreatitis in 20 (30.8%), 11 (16.9%), 11 (16.9%), and 4 patients (6.2%), respectively. Ursodeoxycholic acid (UDCA) was administered to 54 patients (83.1%), leading to stone dissolution in 22 patients (33.8%) within 6 months. Cholecystectomy was performed in 18 patients (27.7%) (mean age, 11.9±5.1 years). Most patients treated surgically had multiple stones (83%) and stones measuring <5 mm in size (89%), and 66.7% of patients had cholesterol stones. CONCLUSION Cholecystectomy is feasible in patients with small-sized or large numbers of GS and those with persistent abdominal pain and/or jaundice. UDCA administration with close follow-up is recommended in patients with uncomplicated GS.
Collapse
Affiliation(s)
- Yeoun Joo Lee
- Department of Pediatrics, Pusan National University School of Medicine, Yangsan, Korea
| | - Yeh Seul Park
- Department of Pediatrics, Pusan National University School of Medicine, Yangsan, Korea
| | - Jae Hong Park
- Department of Pediatrics, Pusan National University School of Medicine, Yangsan, Korea
| |
Collapse
|
|
16
|
Kiani Q, Farooqui F, Khan MS, Khan AZ, Nauman Tariq M, Akhtar A. Association of Body Mass Index and Diet with Symptomatic Gall Stone Disease: A Case-Control Study. Cureus 2020; 12:e7188. [PMID: 32269869 PMCID: PMC7135725 DOI: 10.7759/cureus.7188] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 03/05/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Gall stone disease (GSD) is one of the commonest gastrointestinal disorders. Causative factors can be non-modifiable as genetics and modifiable like dietary habits. High-fat diet and high BMI are well known contributing factors world-over. Local and regional data is deficient about these factors. Moreover, Indo-Pakistani dietary patterns are very different from the western population. This study was conducted to see the association of high BMI and diet with GSD in our population. MATERIALS AND METHODS This case-control study was conducted in Shifa International Hospital, Islamabad, from 2012 to 2017. We included all female patients above 25 years of age with symptomatic gall stones on ultrasonography as cases and all females above 25 years of age with no gall stones on ultrasonography (done for any reason) as controls. The patients with gall stones having some other clear predisposing cause for gallstone formation, e.g., stoma, sudden weight loss, etc. were excluded. BMI, demographic details, dietary habits, and clinical profile of cases and controls were recorded. Data were analyzed by SPSS v 21. p-values were calculated. RESULTS A total of 396 patients were included in this study, with 103 cases and 293 controls. The mean BMI of GSD cases was 27.576±5.753, while controls had a mean BMI of 25.638±7.008 (p=0.08). About 26.4% of cases had an average fat consumption greater than 100g/day as compared to 11.9% controls (p=0.035). The average red meat intake per week was 222g among cases while 210g among controls (p=0.001). The average intake of fried food per week was 270g among controls and 250g among cases (p=0.012). The average intake of bakery items per week was 240g among cases and 210g among controls (p=0.038). CONCLUSION Gall stone disease is significantly related to high BMI and high dietary fat and meat intake in our population.
Collapse
Affiliation(s)
- Qamar Kiani
- General and Colorectal Surgery, Shifa Tameer-E-Millat University, Islamabad, PAK
| | | | | | - Aoun Z Khan
- Surgery, Rawalpindi Medical University, Islambad, PAK
| | | | - Aisha Akhtar
- Surgery, Texas Tech University Health Sciences Center, Lubbock, USA
| |
Collapse
|
|
17
|
Nimanya S, Ocen W, Makobore P, Bua E, Ssekitooleko B, Oyania F. Prevalence and risk factors of gallstone disease in patients undergoing ultrasonography at Mulago hospital, Uganda. Afr Health Sci 2020; 20:383-391. [PMID: 33402926 PMCID: PMC7750090 DOI: 10.4314/ahs.v20i1.44] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Gallstone disease (GSD) is the most prevalent medical condition in the pancreatobiliary system. The burden of GSD and its complications are major public health issues globally. It is a common cause of surgical intervention, contributing substantially to health care costs. Most patients are asymptomatic, however 20% become symptomatic after 10 years. Its prevalence differs among populations and remains unknown in Uganda. Objective To determine the prevalence and risk factors of GSD in patients undergoing abdominal ultrasonography at Mulago hospital, Uganda. Methods This was a cross-sectional study at the Department of Radiology in Mulago hospital. Convenient sampling was used to recruit individuals having an abdominal ultrasound scan. Questionnaires were used to assess risk factors, and an abdominal exam was performed for individuals with gallstones to assess symptomatology. Results The prevalence of GSD was 22%. Statistically significant factors associated with GSD were a history of hormonal contraceptive use OR 3.2 (1.88–5.41) and a history of previous biliary symptoms OR 2.9 (1.68–4.91). Ninety-four percent of individuals with gallstones had epigastric/right upper quadrant pain. Conclusion The prevalence of GSD is high in Mulago hospital; use of hormonal contraceptives and a previous history of biliary symptoms were significant risk factors for GSD in this study. Majority of patients with GSD were symptomatic with epigastric pain as the cardinal symptom. We recommend a countrywide screening program using abdominal ultrasonography to determine the prevalence of GSD in the general population. There is need to study further the risk of hormonal contraceptive use and GSD. Women on these contraceptives should be informed of the potential risk, and offered alternative options where feasible.
Collapse
|
|
18
|
Kaya C, Yang PF, Wong SW, Truskett PG. Outcomes of an acute care surgery model: a 10-year follow-up study. ANZ J Surg 2020; 90:257-261. [PMID: 31943601 DOI: 10.1111/ans.15655] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 10/09/2019] [Accepted: 11/09/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Many hospitals across Australia and New Zealand have implemented acute care surgery (ACS) models over the past decade, often with improved outcomes such as reductions in wait time to surgery, complications and length of stay. The aim of this study was to evaluate the outcomes of patients who underwent non-elective appendicectomy and cholecystectomy and compare these with the results observed shortly after the implementation of an ACS model at our institution 10 years earlier. METHODS A retrospective review of contemporary patients who underwent non-elective appendicectomy and cholecystectomy compared with historical data was performed. Primary outcomes were wait time to surgery, surgical complications and length of stay. RESULTS In the contemporary cohort, 263 patients underwent non-elective appendicectomy over a 1-year period compared with 226 patients in the historical cohort. The median wait time to surgery had increased (17.7 versus 9.6 h, P < 0.001). There was no significant difference in a composite end-point of complications and readmissions (8.0% versus 9.3%, P = 0.61). The length of stay was unchanged. There was greater use of preoperative imaging and reduced overnight operating. For non-elective cholecystectomies, 132 patients underwent this procedure in the contemporary cohort over a 2-year period compared with 115 patients in the historical cohort. There were no significant differences in wait time to surgery (2 versus 1 day, P = 0.13) or complications (9.8% versus 8.7%, P = 0.75). The length of stay was unchanged. CONCLUSION The majority of improvements seen shortly following the implementation of an ACS model have been sustained after 10 years.
Collapse
Affiliation(s)
- Cigdem Kaya
- Faculty of Medicine, The University of New South Wales, Sydney, New South Wales, Australia
| | - Phillip F Yang
- Prince of Wales Clinical School, The University of New South Wales, Sydney, New South Wales, Australia.,Department of Surgery, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Shing W Wong
- Prince of Wales Clinical School, The University of New South Wales, Sydney, New South Wales, Australia.,Department of Surgery, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Philip G Truskett
- Department of Surgery, Prince of Wales Hospital, Sydney, New South Wales, Australia
| |
Collapse
|
|
19
|
Park Y, Kim D, Lee JS, Kim YN, Jeong YK, Lee KG, Choi D. Association between diet and gallstones of cholesterol and pigment among patients with cholecystectomy: a case-control study in Korea. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2017; 36:39. [PMID: 29169372 PMCID: PMC5701373 DOI: 10.1186/s41043-017-0116-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 11/15/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND The prevalence of cholesterol gallstones is high in Western populations, while pigment gallstones are common in Asian populations. Dietary factors are suggested to be associated with gallstone risk, but their relationship with gallstone type has not been evaluated. This study investigated the association between diet and risk of cholesterol gallstone or pigment gallstone in a Korean population whose dietary pattern and type of gallstone were changed during the last 30 years. METHODS Patients with cholesterol (n = 40) and pigment (n = 59) gallstones were recruited after laparoscopic cholecystectomy and were compared with those of age- and sex-matched controls without gallstones (n = 99). Dietary intakes were assessed by trained dietitians using a semi-quantitative food frequency questionnaire. Multinomial logistic regression analysis was performed to calculate odds ratios and 95% confidence intervals to examine the associations between diet and risk for type of gallstones adjusted by potential confounders. RESULTS Patients with cholesterol gallstone consumed more lipid, animal lipid, beef, pork, and fried food than those with pigment gallstones and control, while patients with pigment gallstone consumed more carbohydrate and noodles than patients with cholesterol gallstone and control. In multinomial logistic regression analysis using control as reference group, dietary pattern with high consumption of beef, pork, and fried food was associated with risk of cholesterol gallstones, while there was no association between the risk of pigment gallstone and dietary pattern. In addition, control consumed more alcohol than patients with cholesterol and pigment gallstones. CONCLUSIONS The present study suggested consumption of fat from meat and fried foods increased the risk of cholesterol gallstone, and intake of carbohydrate from noodles increased the risk of pigment gallstone.
Collapse
Affiliation(s)
- Yongsoon Park
- Department of Food and Nutrition, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763 South Korea
| | - Doyeon Kim
- Department of Food and Nutrition, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763 South Korea
| | - Ju Seon Lee
- Department of Food and Nutrition, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763 South Korea
| | - Yu Na Kim
- Department of Food and Nutrition, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763 South Korea
| | - Yoon Kyung Jeong
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763 South Korea
| | - Kyeong Geun Lee
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763 South Korea
| | - Dongho Choi
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763 South Korea
| |
Collapse
|
|
20
|
Jeong YH, Kim KO, Lee HC, Sohn SH, Lee JW, Lee SH, Jang BI, Kim TN. Gallstone prevalence and risk factors in patients with ulcerative colitis in Korean population. Medicine (Baltimore) 2017; 96:e7653. [PMID: 28767582 PMCID: PMC5626136 DOI: 10.1097/md.0000000000007653] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
This study aims to evaluate the prevalence, risk factors, and relative risk of gallstones and associated disease in patients with ulcerative colitis (UC). Medical records of 311 patients diagnosed with UC between January 2004 and February 2015 were reviewed retrospectively. To assess relative risk, 622 patients matched by age, sex, and body mass index were included as a control group. Gallstones were detected in 8% (25/311) of UC patients and in 3.9% (24/622) of the control group. Prevalence was significantly higher in the UC group (odds ratio [OR], 2.178; P = .007). Mean age of gallstone patients was 57.1 ± 17.8 years in the UC group, and mean disease duration of UC was 67.2 ± 38.8 months. The male-to-female ratio of gallstone patients in the UC group was 2.13:1. Mean interval from diagnosis of UC to detection of gallstones was 17.8 ± 30 months. Six UC patients with gallstones underwent cholecystectomy or endoscopic retrograde cholangiography for symptomatic disease and complications. In univariate analysis, diabetes, hypertension, age ≥65 years, and history of more than 3 admissions were significantly associated with gallstone in UC patients. In multivariate analysis, age ≥65 years (OR, 2.655; P = .033) and hospitalization ≥3 times (OR, 4.1; P = .001) were statistically significant risk factors for gallstones in UC patients. This study shows that UC patients have a significantly higher risk of gallstones compared to the general population (OR, 2.178; P = .007), especially those who are older, with a history of multiple admissions.
Collapse
|
|
21
|
Suh SG, Choi YS, Park KW, Lee SE. Pediatric cholecystectomy for symptomatic gallstones unrelated to hematologic disorder. Ann Hepatobiliary Pancreat Surg 2017; 20:187-190. [PMID: 28261698 PMCID: PMC5325154 DOI: 10.14701/ahbps.2016.20.4.187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 09/29/2016] [Accepted: 10/04/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUNDS/AIMS Gallstones are being increasingly diagnosed in pediatric patients. The purpose of this study was to determine characteristics of pediatric patients who underwent cholecystectomy because of symptomatic gallstone disease unrelated to hemolytic disorder. METHODS We reviewed cases of pediatric patients (under 18 years old) who underwent cholecystectomy between May 2005 and December 2015. RESULTS A total 20 pediatric patients (under 18 years old) underwent cholecystectomy during the study period. One patient was excluded because cholecystectomy was performed due to gall stones caused by hemolytic anemia. The 19 cases comprised 9 male (47.3%) and 10 female (52.7%) subjects. The mean age was 14.9 years (range, 5-18), and 66.7% of patients were older than 12 years of age. Mean body weight was 65.0 kg (range, 13.9-93.3), and mean body mass index was 21.7 kg/m2 (range, 12.3-35.1), with 26.37% of patients being overweight. All 19 patients underwent laparoscopic cholecystectomy. There were no postoperative complications and no mortality. Comparison between overweight and non-overweight patients indicated that significantly more overweight patients had cholesterol stones (5/5 vs. 7/14, p=0.036) and were classified as complicated disease (3/5 vs. 1/14, p=0.037). CONCLUSIONS The more frequent occurrence of complications such as choledocholithiasis or gallstone pancreatitis, in overweight patients indicates the need for more careful evaluation and management in these patients. Pediatricians and surgeons should always consider gallstone disease in pediatric patients despite difficulty in suspecting symptomatic gallstones in cases who present with abdominal pain that is rarely clear-cut.
Collapse
Affiliation(s)
- Sang Gyun Suh
- Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Yoo-Shin Choi
- Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Kwi-Won Park
- Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Seung Eun Lee
- Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| |
Collapse
|
|
22
|
Young SH, Peng YL, Lin XH, Chen YT, Luo JC, Wang YP, Hou MC, Lee FY. Cholecystectomy Reduces Recurrent Pancreatitis and Improves Survival After Endoscopic Sphincterotomy. J Gastrointest Surg 2017; 21:294-301. [PMID: 27796634 DOI: 10.1007/s11605-016-3284-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Accepted: 09/17/2016] [Indexed: 01/31/2023]
Abstract
BACKGROUND The aim of this study was to assess whether cholecystectomy can decrease the recurrent pancreatitis in the elderly patients who received endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (EST) and successful clearance of bile duct (BD) stones after gallstone-related acute pancreatitis. METHODS We analyzed data from National Health Insurance Research Database of Taiwan. Elderly patients (age ≧70 years old) who had gallstone-related acute pancreatitis and underwent successful EST with BD stones clearance were eligible for enrollment. This nationwide, population-based, propensity score (PS)-matched cohort study involved two cohorts: (1) patients who underwent cholecystectomy after ERCP with BD stone clearance as study group and (2) those who adopted wait-and-see strategy (without cholecystectomy) after ERCP with BD stone clearance as control group. The primary and secondary endpoints were recurrent acute pancreatitis and all-cause mortality, respectively. RESULTS During the study period, a total of 670 elderly patients (male 291, female 379) with a mean age of 79.1 was enrolled for analysis after PS matching. The incidence rate of recurrent acute pancreatitis was 12.39 per 1000 person-years in the cholecystectomy cohort and 23.94 per 1000 person-years in the PS-matched control cohort. The risk of recurrent acute pancreatitis was significantly lower in the cholecystectomy cohort (HR, 0.56; 95 % confidence interval [CI], 0.34-0.91; P = 0.021). The HR for all-cause mortality among the cholecystectomy cohort was 0.75 (95 % CI, 0.59-0.95; P = 0.016) compared with the control cohort. CONCLUSIONS Cholecystectomy decreased the subsequent recurrent acute pancreatitis and the all-cause mortality in elderly patients with EST and clearance of BD stones after gallstone-related acute pancreatitis.
Collapse
Affiliation(s)
- Shih-Hao Young
- Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Medicine, Division of Gastroenterology and Hepatology, Taipei Veterans General Hospital, 201, Shih-Pai Road, Section 2, Taipei, 11217, Taiwan
| | - Yen-Ling Peng
- Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Medicine, Division of Gastroenterology and Hepatology, Taipei Veterans General Hospital, 201, Shih-Pai Road, Section 2, Taipei, 11217, Taiwan
| | - Xi-Hsuan Lin
- Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Medicine, Division of Gastroenterology and Hepatology, Taipei Veterans General Hospital, 201, Shih-Pai Road, Section 2, Taipei, 11217, Taiwan
| | - Yung-Tai Chen
- Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Department of Medicine, Taipei City Hospital Heping Fuyou Branch, 33, Zhonghua Road, Section 2, Taipei, Taiwan.
| | - Jiing-Chyuan Luo
- Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Department of Medicine, Division of Gastroenterology and Hepatology, Taipei Veterans General Hospital, 201, Shih-Pai Road, Section 2, Taipei, 11217, Taiwan. .,Endoscopic Center for Diagnosis and Therapy, Taipei Veterans General Hospital, Taipei, Taiwan.
| | - Yen-Po Wang
- Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Endoscopic Center for Diagnosis and Therapy, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ming-Chih Hou
- Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Medicine, Division of Gastroenterology and Hepatology, Taipei Veterans General Hospital, 201, Shih-Pai Road, Section 2, Taipei, 11217, Taiwan.,Endoscopic Center for Diagnosis and Therapy, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Fa-Yauh Lee
- Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Medicine, Division of Gastroenterology and Hepatology, Taipei Veterans General Hospital, 201, Shih-Pai Road, Section 2, Taipei, 11217, Taiwan
| |
Collapse
|
|
23
|
Park DJ, Kim KH, Park YS, Ahn SH, Park DJ, Kim HH. Risk Factors for Gallstone Formation after Surgery for Gastric Cancer. J Gastric Cancer 2016; 16:98-104. [PMID: 27433395 PMCID: PMC4944009 DOI: 10.5230/jgc.2016.16.2.98] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 04/26/2016] [Accepted: 04/26/2016] [Indexed: 12/12/2022] Open
Abstract
Purpose The incidence of gallstones after gastrectomy for gastric cancer is higher than in the general population. However, the causes and mechanisms of post-gastrectomy gallstones are unclear. The aim of this study was to evaluate the incidence of gallstone formation and the risk factors for their development after gastrectomy for gastric cancer. Materials and Methods Of 1,744 gastric cancer patients who underwent gastrectomy at Seoul National University Bundang Hospital between January 2010 and December 2012, 1,284 were included in this study and retrospectively reviewed. Patients' age, sex, body mass index (BMI), tumor location, stage, type of gastrectomy, type of reconstruction, and extent of node dissection were evaluated. Results The incidence of gallstones after gastrectomy for gastric cancer was significantly higher in men than in women (P=0.019). Exclusion of the duodenum during reconstruction was associated with a significantly higher incidence of gallstones (P=0.003). Overweight and obese patients with BMI ≥23 kg/m2 had significantly higher incidence of gallstones than those with a lower BMI (P=0.006). Multivariate analysis showed that obesity (hazard ratio, HR=1.614; 95% confidence interval, CI: 1.135~2.296; P=0.008), male sex (HR=1.515, 95% CI: 1.029~2.231, P=0.033), and exclusion of the duodenum (HR=1.648, 95% CI: 1.192~2.280, P=0.003) were significant, independent risk factors for gallstones after gastrectomy. Conclusions The cumulative incidence of gallstones for 5 years after gastrectomy was 15.3%. Male sex, obesity, and exclusion of the duodenum were risk factors for gallstone formation after gastrectomy. Careful surveillance will be required for these patient groups after gastrectomy.
Collapse
Affiliation(s)
- Dong Jin Park
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ki Hyun Kim
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Young Suk Park
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sang-Hoon Ahn
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.; Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Do Joong Park
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.; Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hyung-Ho Kim
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.; Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
|
24
|
Hyun JJ, Lee HS, Kim CD, Dong SH, Lee SO, Ryu JK, Lee DH, Jeong S, Kim TN, Lee J, Koh DH, Park ET, Lee IS, Yoo BM, Kim JH. Efficacy of Magnesium Trihydrate of Ursodeoxycholic Acid and Chenodeoxycholic Acid for Gallstone Dissolution: A Prospective Multicenter Trial. Gut Liver 2016; 9:547-55. [PMID: 26087862 PMCID: PMC4478000 DOI: 10.5009/gnl15015] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background/Aims Cholecystectomy is necessary for the treatment of symptomatic or complicated gallbladder (GB) stones, but oral litholysis with bile acids is an attractive alternative therapeutic option for asymptomatic or mildly symptomatic patients. This study was conducted to evaluate the efficacy of magnesium trihydrate of ursodeoxycholic acid (UDCA) and chenodeoxycholic acid (CDCA) on gallstone dissolution and to investigate improvements in gallstone-related symptoms. Methods A prospective, multicenter, phase 4 clinical study to determine the efficacy of orally administered magnesium trihydrate of UDCA and CDCA was performed from January 2011 to June 2013. The inclusion criteria were GB stone diameter ≤15 mm, GB ejection fraction ≥50%, radiolucency on plain X-ray, and asymptomatic/mildly symptomatic patients. The patients were prescribed one capsule of magnesium trihydrate of UDCA and CDCA at breakfast and two capsules at bedtime for 6 months. The dissolution rate, response rate, and change in symptom score were evaluated. Results A total of 237 subjects were enrolled, and 195 subjects completed the treatment. The dissolution rate was 45.1% and the response rate was 47.2% (92/195) after 6 months of administration of magnesium trihydrate of UDCA and CDCA. Only the stone diameter was significantly associated with the response rate. Both the symptom score and the number of patients with symptoms significantly decreased regardless of stone dissolution. Adverse events necessitating discontinuation of the drug, surgery, or endoscopic management occurred in 2.5% (6/237) of patients. Conclusions Magnesium trihydrate of UDCA and CDCA is a well-tolerated bile acid that showed similar efficacy for gallstone dissolution and improvement of gallstone-related symptoms as that shown in previous studies.
Collapse
Affiliation(s)
- Jong Jin Hyun
- Department of Internal Medicine, Korea University College of Medicine, Korea
| | - Hong Sik Lee
- Department of Internal Medicine, Korea University College of Medicine, Korea
| | - Chang Duck Kim
- Department of Internal Medicine, Korea University College of Medicine, Korea
| | - Seok Ho Dong
- Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Seung-Ok Lee
- Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea
| | - Ji Kon Ryu
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Don Haeng Lee
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
| | - Seok Jeong
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
| | - Tae Nyeun Kim
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Jin Lee
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Dong Hee Koh
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Eun Taek Park
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - In-Seok Lee
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Byung Moo Yoo
- Department of Internal Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Jin Hong Kim
- Department of Internal Medicine, Ajou University School of Medicine, Suwon, Korea
| |
Collapse
|
|
25
|
Ahn KS, Kim YH, Kang KJ, Kim TS, Cho KB, Kim ES. Impact of Preoperative ERCP on Laparoscopic Cholecystectomy: A Case-Controlled Study with Propensity Score Matching. World J Surg 2016; 39:2235-42. [PMID: 25894408 DOI: 10.1007/s00268-015-3076-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Although inflammation induced by endoscopic retrograde cholangiopancreatography (ERCP) may affect laparoscopic cholecystectomy (LC), making the procedure more difficult, clinical impact of ERCP on LC is unclear. The aim of this study was to evaluate the effects of ERCP on LC and to determine appropriate time of LC after ERCP. METHODS Six hundred twenty-one patients who underwent LC for gallstone disease were enrolled. These patients were divided into two groups; patients with preoperative ERCP prior to LC (ERCP group) and patients who underwent LC without ERCP (non-ERCP group). Among these patients, patients who had shown acute cholecystitis or cholangitis were excluded. To control for different demographic factors in the two groups, propensity score case matching was used at a 1:1 ratio. Finally, 142 patients were matched with 71 patients of the ERCP group and 71 patients of the non-ERCP group. Intraoperative inflammation degree, technical difficulty, and postoperative outcome were analyzed. RESULTS In the ERCP group, the degree of inflammation was severe and operations were more difficult than those of the non-ERCP group. The operation time was longer, and rates of open conversion were higher in the ERCP group. On multivariate analysis, preoperative ERCP was significant factor for difficult operations. The difficulty of operation was not different according to the operation timing after ERCP. CONCLUSION Preoperative ERCP is a significant factor in difficult LC. Therefore, experienced surgeons should perform LC after preoperative ERCP. Since operation difficulty was similar according to the timing of cholecystectomy after ERCP, there is no reason to delay LC after ERCP.
Collapse
Affiliation(s)
- Keun Soo Ahn
- Department of Surgery, Dongsan Medical Center, Keimyung University School of Medicine, 56 Dalseong-ro, Jung-gu, Daegu, 700-712, Republic of Korea,
| | | | | | | | | | | |
Collapse
|
|
26
|
Radmard AR, Merat S, Kooraki S, Ashraf M, Keshtkar A, Sharafkhah M, Jafari E, Malekzadeh R, Poustchi H. Gallstone disease and obesity: a population-based study on abdominal fat distribution and gender differences. Ann Hepatol 2015; 14:702-709. [PMID: 26256899 DOI: 10.1016/s1665-2681(19)30765-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
BACKGROUND Existing evidence suggests the visceral fat is more metabolically active than subcutaneous fat. We aimed to investigate the value of subcutaneous (SAT) and visceral adipose tissue thickness (VAT) for prediction of gallstone disease (GSD) in general population by focus on gender differences and comparison with body mass index (BMI), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR). MATERIAL AND METHODS In this cross-sectional survey, 1,494 subjects (51.4 % men), aged above 50, randomly selected from Golestan Cohort Study residing in Gonbad City, Iran, underwent anthropometric measurements and abdominal ultrasonography. RESULTS Prevalence of GSD was 17.8% (95% CI 15.9-19.8). Following adjustment for age and then other potential risk factors, all obesity indices, except for SAT, were associated with GSD in women with the highest odds ratio observed in WHtR (OR 1.52, 95% CI 1.22-1.89). In contrast, WHR was the only associated index in men (OR 1.49, 95% CI 1.08-2.06). The trend of increasing obesity measures across the quartiles with the risk of GSD was significant in subgroups of WHtR and BMI in women and WHR in men. No significant association was found between SAT and GSD in men or women. CONCLUSIONS The best anthropometric indicators of the risk of GSD may differ by gender. In men, WHR might be the only preferred index to estimate risk of GSD. WHtR, WHR, VAT and BMI are associated with GSD risk in women, although WHtR might better explain this risk. SAT is the poor indicator for identifying subjects with GSD in both genders.
Collapse
Affiliation(s)
- Amir Reza Radmard
- Department of Radiology, Shariati hospital, Tehran University of Medical Sciences. Tehran, Iran
| | - Shahin Merat
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences. Tehran, Iran
| | - Soheil Kooraki
- Department of Radiology, Shariati hospital, Tehran University of Medical Sciences. Tehran, Iran
| | - Mahya Ashraf
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences. Tehran, Iran
| | - Abbas Keshtkar
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences. Tehran, Iran
| | - Maryam Sharafkhah
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences. Tehran, Iran
| | - Elham Jafari
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences. Tehran, Iran
| | - Reza Malekzadeh
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences. Tehran, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences. Tehran, Iran
| |
Collapse
|
|
27
|
Comparison of laparoscopic versus open left-sided hepatectomy for intrahepatic duct stones. Surg Endosc 2015; 30:259-65. [PMID: 25861904 DOI: 10.1007/s00464-015-4200-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 03/31/2015] [Indexed: 12/23/2022]
Abstract
BACKGROUND Laparoscopic hepatectomy for intrahepatic duct (IHD) stones is limited by technical difficulties caused by adhesion to adjacent tissue or distorted anatomy resulting from recurrent inflammation. This study compared perioperative and clinical outcomes in patients undergoing laparoscopic and open hepatectomy for left IHD stones. METHODS From January 2002 to December 2013, 40 patients underwent laparoscopic left-sided hepatectomy [left hemihepatectomy (n = 7) or left lateral sectionectomy (n = 33)] and 54 patients without combined operations and previous operation histories underwent open left-sided hepatectomy [left hemihepatectomy (n = 24) or left lateral sectionectomy (n = 30)]. Their perioperative and clinical outcomes were compared, including stone clearance rates, stone recurrence rates, and median follow-up duration. RESULTS There was no difference in age (56.8 ± 8.2 vs. 55.6 ± 9.6 years, p = 0.531), sex (1.0:4.0 vs. 1.0:1.8 male:female, p = 0.108), or BMI (22.8 ± 2.8 vs. 22.9 ± 3.0 kg/m(2), p = 0.802) between the laparoscopic and open hepatectomy groups. Lateral sectionectomy was more frequent in the laparoscopic group (33/40 vs. 30/54, p = 0.010). Operation time (174.2 ± 56.6 vs. 210.4 ± 51.6 min, p = 0.002) and postoperative hospital stay (7.9 ± 2.6 vs. 14.3 ± 5.5 days, p < 0.001) were shorter in the laparoscopic group, and complication rate (17.5 vs. 40.7%, p = 0.016), in particular surgical site infection rate (5.0 vs. 18.5%, p = 0.052), was lower in the laparoscopic group than in the open hepatectomy group. Similar results were observed in the hemihepatectomy and lateral sectionectomy subgroups. There was no operation-related mortality. There were no significant differences in follow-up periods (48 ± 33.6 vs. 59.2 ± 41.7 months, p = 0.235) and rates of initial stone clearance (87.5 vs. 75.9%, p = 0.159), final clearance (100 vs. 94.4%, p = 0.130), and stone recurrence (2.5 vs. 5.6%, p = 0.468). CONCLUSION Laparoscopic hepatectomy is safe and effective for well-selected patients with left IHD stones, when performed by experienced surgeons. Laparoscopic hepatectomy resulted in shorter operation time and postoperative hospital stay, and a lower postoperative morbidity rate, than open hepatectomy.
Collapse
|
|
28
|
Ha JH, Park YS, Seon CS, Son BK, Ahn SB, Jo YK, Kim SH, Jo YJ, Kim JH, Han JH, Jung YY, Chung SH. Increased risk of asymptomatic gallstones in patients with ulcerative colitis. Intest Res 2015; 13:122-7. [PMID: 25931996 PMCID: PMC4414753 DOI: 10.5217/ir.2015.13.2.122] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 10/24/2014] [Accepted: 10/24/2014] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND/AIMS The relationship between Crohn's disease and gallstones is established. However, the prevalence and risk factors for gallstones in patients with ulcerative colitis (UC) are not yet well understood. The aim of this study was to evaluate the prevalence and risk factors of gallstones in patients with UC. METHODS This study was a retrospective single center study. A total of 87 patients with UC and 261 healthy controls were enrolled. Age, sex, and body mass index were matched. To investigate risk factors, the extent of UC, duration of disease, number of hospital admissions, and number of steroid treatments in patients with UC were evaluated. RESULTS The prevalence of gallstones in patients with UC was 13.8%, whereas that in healthy controls was only 3.1% (P<0.001). For patients with UC, patients ≥50 years of age had a 3.6-times higher risk of gallstones compared to that in those <50 years of age, and the difference was statistically significant (odds ratio, 3.60; confidence interval, 1.03-12.61) in univariate analysis. There were no statistically significant disease-related risk factors for gallstones in UC patients. CONCLUSIONS This is the first study of gallstone prevalence in Korean UC patients. In this study, patients with UC had a higher prevalence of gallstones compared to that in well-matched healthy controls. Age seemed to be a possible risk factor, and more studies are needed. Further prospective, large-scale studies will be required to confirm the risk factors for gallstones in UC patients.
Collapse
Affiliation(s)
- Jung Hoon Ha
- Department of Gastroenterology, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea
| | - Young Sook Park
- Department of Gastroenterology, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea
| | - Choon Sik Seon
- Department of Gastroenterology, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea
| | - Byung Kwan Son
- Department of Gastroenterology, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea
| | - Sang Bong Ahn
- Department of Gastroenterology, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea
| | - Young Kwan Jo
- Department of Gastroenterology, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea
| | - Seong Hwan Kim
- Department of Gastroenterology, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea
| | - Yun Ju Jo
- Department of Gastroenterology, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea
| | - Jung Hwan Kim
- Department of Family Medicine, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea
| | - Jee Hye Han
- Department of Family Medicine, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea
| | - Yoon Young Jung
- Department of Radiology, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea
| | - Sook Hee Chung
- Department of Gastroenterology, Ajou University College of Medicine, Suwon, Korea
| |
Collapse
|
|
29
|
Pålsson SH, Sandblom G. Influence of gender and socioeconomic background on the decision to perform gallstone surgery: a population-based register study. Scand J Gastroenterol 2015; 50:211-6. [PMID: 25413566 DOI: 10.3109/00365521.2014.978818] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND In the absence of unequivocal standardized indications for surgery, socioeconomic background and gender may have a major impact on the decision to perform surgery for cholecystolithiasis. The purpose was to assess how decisions to perform surgery in Sweden are influenced by patient-related factors and how this affects the epidemiology of gallstone disease. MATERIALS AND METHODS This study is based on the Swedish Register for Gallstone Surgery and Endoscopic Retrograde Cholangiopancreatography (GallRiks), which covers >90% of surgical units, including 98% of all procedures performed. All procedures performed during 2005-2009 were included. Data on socioeconomic background were obtained from Statistics Sweden. The influence of gender and age on decision to perform surgery was tested in multivariate linear regression analysis. RESULTS Up to the age of 40 years, women were 6 times more likely than men to undergo surgery for biliary colic. On the other hand, there was a relative preponderance of men undergoing cholecystectomy for jaundice, cholecystitis, bile duct stone or pancreatitis in the elderly population (p < 0.001). Socioeconomic background did not have any significant impact on the decision to operate. CONCLUSION Presentations of gallstone disease differ between men and women, as does the decision to perform surgery. The higher incidence of surgery for secondary complications in older men could be explained by a higher prevalence of gallstones resulting from a lower incidence of surgery at a younger age. Whether or not wider indications for surgery in young patients reduce the risk for gallstone complications requiring surgery should be explored in future studies.
Collapse
Affiliation(s)
- Simon H Pålsson
- Department of Surgery, Sahlgrenska University Hospital , Östra, Gothenburg , Sweden
| | | |
Collapse
|
|
30
|
Liu F, Bai X, Duan GF, Tian WH, Li ZS, Song B. Comparative quality of life study between endoscopic sphincterotomy and surgical choledochotomy. World J Gastroenterol 2014; 20:8237-8243. [PMID: 25009398 PMCID: PMC4081698 DOI: 10.3748/wjg.v20.i25.8237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Accepted: 04/16/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To determine quality of life improvement in choledocholithiasis patients who underwent endoscopic sphincterotomy (EST) versus open choledochotomy (OCT).
METHODS: Eligible choledocholithiasis patients (n = 216) hospitalized in the Changhai Hospital between May 2010 and January 2011 were enrolled into a prospective study using cluster sampling. Patients underwent EST (n = 135) or OCT (n = 81) depending on the patient’s wishes. Patients were followed-up with a field survey and by correspondence. Patients were also given the self-administered Gastrointestinal Quality of Life Index (GIQLI) to measure patient quality of life before surgery, and at two and six weeks after the procedures.
RESULTS: With respect to baseline patient characteristics, the EST and OCT groups were comparable. After the procedure, gallstones were completely eliminated in all patients. Among 216 eligible patients, 191 patients (88.4%) completed all three surveys, including 118 patients who underwent EST (118/135; 87.4%) and 73 patients who underwent OCT (73/81; 90.1%). EST was associated with a significantly shorter hospital stay than OCT (8.8 ± 6.5 vs 13.9 ± 6.7 d; P < 0.001). The GIQLI score was similar between the EST and OCT groups before cholelithotomy (103.0 ± 15.4 vs 99.7 ± 10.2), but increased significantly in the EST group at two weeks (113.4 ± 12.0 vs 107.2 ± 11.2; P < 0.001) and six weeks (120.7 ± 10.6 vs 116.9 ± 7.5; P < 0.05) after the procedures.
CONCLUSION: EST, compared with OCT, is associated with better postoperative quality of life in patients treated for choledocholithiasis.
Collapse
|