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Liu P, Chen YW, Liu C, Wu YT, Zhao WC, Zhu JY, An Y, Xia NX. Development and validation of a nomogram model for predicting the risk of gallstone recurrence after gallbladder-preserving surgery. Hepatobiliary Pancreat Dis Int 2024; 23:288-292. [PMID: 36443144 DOI: 10.1016/j.hbpd.2022.11.001] [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: 01/10/2022] [Accepted: 10/25/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND The high incidence of gallstone recurrence was a major concern for laparoscopic gallbladder-preserving surgery. This study aimed to investigate the risk factors for gallstone recurrence after gallbladder-preserving surgery and to establish an individualized nomogram model to predict the risk of gallstone recurrence. METHODS The clinicopathological and follow-up data of 183 patients who were initially diagnosed with gallstones and treated with gallbladder-preserving surgery at our hospital from January 2012 to January 2019 were retrospectively collected. The independent predictive factors for gallstone recurrence following gallbladder-preserving surgery were identified by multivariate logistic regression analysis. A nomogram model for the prediction of gallstone recurrence was constructed based on the selected variables. The C-index, receiver operating characteristic (ROC) curve and calibration curve were used to evaluate the predictive power of the nomogram model for gallstone recurrence. RESULTS During the follow-up period, a total of 65 patients experienced gallstone recurrence, and the recurrence rate was 35.5%. Multivariate logistic regression analysis revealed that the course of gallstones > 2 years [odds ratio (OR) = 2.567, 95% confidence interval (CI): 1.270-5.187, P = 0.009], symptomatic gallstones (OR = 2.589, 95% CI: 1.059-6.329, P = 0.037), multiple gallstones (OR = 2.436, 95% CI: 1.133-5.237, P = 0.023), history of acute cholecystitis (OR = 2.778, 95% CI: 1.178-6.549, P = 0.020) and a greasy diet (OR = 2.319, 95% CI: 1.186-4.535, P = 0.014) were independent risk factors for gallstone recurrence after gallbladder-preserving surgery. A nomogram model for predicting the recurrence of gallstones was established based on the above five variables. The results showed that the C-index of the nomogram model was 0.692, suggesting it was valuable to predict gallstone recurrence. Moreover, the calibration curve showed good consistency between the predicted probability and actual probability. CONCLUSIONS The nomogram model for the prediction of gallstone recurrence might help clinicians develop a proper treatment strategy for patients with gallstones. Gallbladder-preserving surgery should be cautiously considered for patients with high recurrence risks.
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Affiliation(s)
- Peng Liu
- Faculty of Hepato-Pancreato-Biliary Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China; Institute of Hepatobiliary Surgery of Chinese PLA, Beijing 100853, China; Key Laboratory of Digital Hepetobiliary Surgery of Chinese PLA, Beijing 100853, China
| | - Yong-Wei Chen
- Faculty of Hepato-Pancreato-Biliary Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China; Institute of Hepatobiliary Surgery of Chinese PLA, Beijing 100853, China; Key Laboratory of Digital Hepetobiliary Surgery of Chinese PLA, Beijing 100853, China
| | - Che Liu
- Faculty of Hepato-Pancreato-Biliary Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China; Institute of Hepatobiliary Surgery of Chinese PLA, Beijing 100853, China; Key Laboratory of Digital Hepetobiliary Surgery of Chinese PLA, Beijing 100853, China
| | - Yin-Tao Wu
- Faculty of Hepato-Pancreato-Biliary Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China; Institute of Hepatobiliary Surgery of Chinese PLA, Beijing 100853, China; Key Laboratory of Digital Hepetobiliary Surgery of Chinese PLA, Beijing 100853, China
| | - Wen-Chao Zhao
- Faculty of Hepato-Pancreato-Biliary Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China; Institute of Hepatobiliary Surgery of Chinese PLA, Beijing 100853, China; Key Laboratory of Digital Hepetobiliary Surgery of Chinese PLA, Beijing 100853, China
| | - Jian-Yong Zhu
- Faculty of Hepato-Pancreato-Biliary Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China; Institute of Hepatobiliary Surgery of Chinese PLA, Beijing 100853, China; Key Laboratory of Digital Hepetobiliary Surgery of Chinese PLA, Beijing 100853, China
| | - Yang An
- Faculty of Hepato-Pancreato-Biliary Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China; Institute of Hepatobiliary Surgery of Chinese PLA, Beijing 100853, China; Key Laboratory of Digital Hepetobiliary Surgery of Chinese PLA, Beijing 100853, China
| | - Nian-Xin Xia
- Faculty of Hepato-Pancreato-Biliary Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China; Institute of Hepatobiliary Surgery of Chinese PLA, Beijing 100853, China; Key Laboratory of Digital Hepetobiliary Surgery of Chinese PLA, Beijing 100853, China.
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Pan X, Wang S, Jia B, Yue L, Chen S. Epidemiological Characterisation of Chronic Diseases Among Civil Servants in Hebei Province, China: A Cross-Sectional Real-World Study of Approximately 50,000 Adults. Risk Manag Healthc Policy 2024; 17:1301-1313. [PMID: 38778923 PMCID: PMC11108759 DOI: 10.2147/rmhp.s457345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 05/05/2024] [Indexed: 05/25/2024] Open
Abstract
Background The objective of this investigation was to explore the health status and epidemiological features of civil servants working in Hebei Province, China. Methods Data was collected through a cross-sectional survey that involved 50,039 adult civil servants in Hebei Province. The research was conducted at the Hebei Provincial Medical Examination Centre and included inquiries about demographics, health behaviours, chronic illnesses, and abnormal check-up indicators. Statistical data were used to determine the prevalence of chronic diseases and abnormal health examination indicators. Subgroup analyses by sex were then conducted to calculate the similarities and differences in health status between men and women. Results The findings of the survey indicate that 14.2% of individuals who work in civil service suffer from obesity. Additionally, a considerable proportion of this group display poor health behaviours, including smoking and alcohol consumption. Hypertension (21.03%), dyslipidaemia (10.88%), and diabetes mellitus (8.56%) were identified as the top three chronic diseases, while cardiovascular diseases were prevalent at 6.27% among civil servants. Ultrasound showed a high prevalence of fatty liver, non-smooth gallbladder and liver cysts (44.61%, 33.24% and 23.26% respectively). The occurrence of pulmonary nodules was alarmingly high at 88.48%, while thyroid nodules were found in as much as 62.65% of patients. Abnormal E/A values≤1, prostate hyperplasia, breast nodules, and carotid plaques were also prevalent, with percentages ranging from 46.76% to 63.04%. In subgroup analyses by gender, the prevalence of chronic diseases and abnormal screening indicators was consistently higher in men than in women, with the exception of thyroid nodules and thyroid surgery. Conclusion The survey revealed a large proportion of civil servants in Hebei Province, China, suffering from chronic diseases, underscoring the necessity for enhanced attention to chronic disease prevention and management in this group and emphasising the requirement for focused interventions aimed at improving health outcomes.
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Affiliation(s)
- Xiaoyu Pan
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
| | - Shuqi Wang
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
| | - Boying Jia
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
| | - Lin Yue
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
- Department of Endocrinology, The Third Hospital of Shijiazhuang, Shijiazhuang, Hebei, People’s Republic of China
| | - Shuchun Chen
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
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Kweon OS, Heo J, Jung MK. Comparison Study between ERCP and PTBD for Recurrent Choledocholithiasis in Patients Following Gastrectomy. Diagnostics (Basel) 2023; 13:2651. [PMID: 37627910 PMCID: PMC10453114 DOI: 10.3390/diagnostics13162651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/07/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
The recurrence rate of choledocholithiasis in the general population has been reported to exceed 10%. The incidence of cholelithiasis was reported to be higher in patients following gastrectomy than that in the general population. However, there is no study for recurrent choledocholithiasis incidence in patients following gastrectomy. This study aimed to evaluate the recurrence rate of choledocholithiasis and identify risk factors for recurrent choledocholithiasis in patients following gastrectomy. A retrospective analysis was performed on patients with gastrectomy history who underwent choledocholithiasis removal in Kyungpook National University Hospital between January 2011 and December 2019. Choledocholithiases were treated by endoscopic retrograde cholangiopancreatography (ERCP) (n = 41) or percutaneous transhepatic biliary drainage (PTBD) (n = 90). The gastrectomy type was classified as subtotal gastrectomy with Billroth I (18.3%), Billroth II (45.0%), and total gastrectomy with Roux-en-Y (36.6%). During a median follow-up period of 31.5 (range, 6-105) months, choledocholithiasis recurrence was noted in 19 of 131 patients (14.5%). In subgroup analysis, the ERCP group (24.4%) had higher choledocholithiasis recurrence than the PTBD group (10.0%). Stone removal modality (ERCP), no use of balloon sphincteroplasty, and the presence of periampullary diverticulum were significant risk factors for recurrent choledocholithiasis. In multivariate analysis, ERCP (hazard ratio (HR), 3.597; 95% confidence interval (CI): 1.264-10.204) CBD stricture (HR, 3.823; 95% CI: 1.118-13.080) and no use of balloon sphincteroplasty (HR, 4.830; 95% CI: 1.669-13.889) were risk factors for recurrent choledocholithiasis following stone removal. The incidence of CBD stones in patients who underwent gastrectomy is similar to that of the general population. ERCP, CBD stricture, and no use of balloon sphincteroplasty are potential risk factors for recurrent CBD stones following gastrectomy. When we consider PTBD disadvantages, the ERCP procedure with active use of balloon sphincteroplasty is recommended to decrease recurrent CBD stones.
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Affiliation(s)
- O Seong Kweon
- School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu 41944, Republic of Korea
| | - Jun Heo
- School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu 41944, Republic of Korea
| | - Min Kyu Jung
- School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu 41944, Republic of Korea
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Li G, Yu T, Du H, Zhang L, Liu X, Hou S. Effect of Clostridium butyricum on the formation of primary choledocholithiasis based on intestinal microbiome and metabolome analysis. J Appl Microbiol 2023; 134:lxad170. [PMID: 37533214 DOI: 10.1093/jambio/lxad170] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 07/11/2023] [Accepted: 08/01/2023] [Indexed: 08/04/2023]
Abstract
AIMS To investigate the function and probable mechanism of Clostridium butyricum in the development of choledocholithiasis. METHODS AND RESULTS The lithogenic diet group and the lithogenic diet + C. butyricum group were used to develop the choledocholithiasis model. During the experiment, C. butyricum suspension was administered to the rats in the lithogenic diet + C. butyricum group. The findings demonstrated that the C. butyricum intervention decreased the Firmicutes/Bacteroidetes ratio in the colon of experimental animals given a lithogenic diet. The relative levels of Desulfovibrio (0.93%) and Streptococcus (0.38%) fell, whereas Lactobacillus (22.36%), Prevotella (14.09%), and bacteria that produce short-chain fatty acids increased. Finally, 68 distinct metabolic products were found based on nontargeted metabonomics, and 42 metabolic pathways associated to the various metabolites were enriched. CONCLUSIONS We found that C. butyricum decreased the development of choledocholithiasis. It keeps the equilibrium of the rat's gut microbiome intact and lowers the danger of bacterial infections of the gastrointestinal and biliary systems. It is hypothesized that by controlling lipid metabolism, it may also have an impact on the development of cholelithiasis.
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Affiliation(s)
- Guofu Li
- Biliopancreatic Endoscopic Surgery Department, The Second Hospital of Hebei Medical University, 050000 Shijiazhuang, P. R. China
| | - Tingting Yu
- Biliopancreatic Endoscopic Surgery Department, The Second Hospital of Hebei Medical University, 050000 Shijiazhuang, P. R. China
| | - Haiming Du
- Biliopancreatic Endoscopic Surgery Department, The Second Hospital of Hebei Medical University, 050000 Shijiazhuang, P. R. China
| | - Lichao Zhang
- Biliopancreatic Endoscopic Surgery Department, The Second Hospital of Hebei Medical University, 050000 Shijiazhuang, P. R. China
| | - Xiaoxuan Liu
- Hebei Provincial Center for Clinical Laboratories, The Second Hospital of Hebei Medical University, 050000 Shijiazhuang, P. R. China
| | - Senlin Hou
- Biliopancreatic Endoscopic Surgery Department, The Second Hospital of Hebei Medical University, 050000 Shijiazhuang, P. R. China
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Liu G, Zheng X, Jia Y, Cao P, Jiang Z, Yang L. Sex-dependent difference in the relationship between thyroid hormones and gallstone disease in euthyroid subjects. Medicine (Baltimore) 2023; 102:e34007. [PMID: 37335641 PMCID: PMC10256348 DOI: 10.1097/md.0000000000034007] [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: 03/14/2023] [Accepted: 05/24/2023] [Indexed: 06/21/2023] Open
Abstract
The relationship between thyroid dysfunction and gallstone disease (GSD) has been examined by some observational studies. However, evidence about the relationship between thyroid function and GSD among euthyroid subjects was scarce. The aim of this study was to investigate the association between thyroid function and the presence of GSD in a large-sample euthyroid subjects. A total of 5476 euthyroid subjects who underwent health checkup were included. GSD was diagnosed by hepatic ultrasonography. Conventional risk factors for GSD were assessed as well as serum levels of TSH, TT3, TT4 and Log-transformed TT3/TT4 ratio. A total of 4958 subjects were finally included. Levels of TSH, TT3, TT4, and ln (TT3/TT4) were comparable between GSD and non-GSD group (TSH: 1.73 ± 1.07 vs 1.74 ± 1.07 mIU/L, P = .931; TT3: 1.55 ± 0.40 vs 1.54 ± 0.39 ng/mL, P = .797; TT4: 9.37 ± 2.07 vs 9.49 ± 2.06 ug/dL, P = .245, ln (TT3/TT4): -1.80 ± 0.23 vs -1.83 ± 0.23, P = .130, respectively). Multivariate logistic regression analysis among all subjects revealed that the thyroid function parameters did not reach significant difference. Subgroup analyses showed that the relationship between thyroid function and GSD was different according to gender, with negative association for ln (TT3/TT4) and (odds ratio:0.551, 95% CI: 0.306-0.992, P = .047) and positive association for TT4 (odds ratio:1.077, 1 95% CI: .001-1.158, P = .046) in men. None of the thyroid function parameters was significantly associated with GSD in women. Our findings indicated that low levels of TT3-to-TT4 ratio and high levels of TT4 were significantly and independently associated with GSD among euthyroid male subjects, but not female subjects.
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Affiliation(s)
- Guoli Liu
- Department of Geriatrics and Respiratory Medicine, The Affiliated Taian City Central Hospital of Qingdao University, Taian City, Shandong Province, P. R. China
| | - Xiao Zheng
- Department of Gastrointestinal Surgery. The Affiliated Taian City Central Hospital of Qingdao University, Taian City, Shandong Province, P. R. China
| | - Yuzhen Jia
- Department of Geriatrics and Respiratory Medicine, The Affiliated Taian City Central Hospital of Qingdao University, Taian City, Shandong Province, P. R. China
| | - Ping Cao
- Department of Geriatrics and Respiratory Medicine, The Affiliated Taian City Central Hospital of Qingdao University, Taian City, Shandong Province, P. R. China
| | - Zhi Jiang
- Department of Geriatrics and Respiratory Medicine, The Affiliated Taian City Central Hospital of Qingdao University, Taian City, Shandong Province, P. R. China
| | - Libo Yang
- Department of Endocrinology, The Affiliated Taian City Central Hospital of Qingdao University, Taian City, Shandong Province, P.R. China
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Zhang F, Huang J, Yang J, Wang Y, Qiu B. Laparoscopic versus Conventional Surgery for Acute Cholangitis of Severe Type: A Systematic Review of Randomized Controlled Trials. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:6828476. [PMID: 35756417 PMCID: PMC9225883 DOI: 10.1155/2022/6828476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/25/2022] [Accepted: 05/28/2022] [Indexed: 12/07/2022]
Abstract
Objective Currently, the choice between laparoscopic surgery and conventional laparotomy in the surgical treatment of acute cholangitis of severe type (ACST) is debatable. This study compared the clinical efficacy of these two surgical methods through a meta-analysis based on relevant clinical randomized controlled trials (RCT) on ACST. Methods We systematically searched several databases (PubMed, Web of Science, Embase, China National Knowledge Infrastructure, and WangFang) for RCT on the surgical treatment of ACST between 2010 and 2022. Relevant data were extracted, and a meta-analysis was performed using the statistical software Stata 16.0. Results From initial 1089 studies retrieved, 15 studies (n = 1247 patients) were eligible. The total number of patients was 1247, of whom 635 were classified in the treatment group (laparoscopic surgery) and 612 patients in the control group (conventional laparotomy). This meta-analysis showed that compared with conventional laparotomy, laparoscopic surgery was associated with higher effective rate (OR = 3.808, 95% CI [2.383, 6.085], P < 0.001), lower incidence rate of complications (OR = 0.192, 95% CI [0.139, 0.265], P < 0.001), shorter operation duration (SMD = -3.274, 95% CI [-4.503, -2.045], P < 0.001), and shorter postoperative hospital stay (SMD = -2.432, 95% CI [-2.988, -1.877], P < 0.001). Further, the indicators of symptomatic relief (anus exhaust time, jaundice relief time, gastrointestinal function recovery time, and abdominal pain relief time) and inflammatory levels (white blood cell count, alanine aminotransferase, total bilirubin level, and high-sensitivity C-reactive protein level) in the treatment group were better than those in the control group. Conclusion Laparoscopic surgery was associated with significant improvement in treatment efficiency, reduced risk of complications, and better treatment outcomes in patients with ACST.
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Affiliation(s)
- Fang Zhang
- Critical Care Medicine, Shengzhou People's Hospital (The First Affiliated Hospital of Zhejiang University Shengzhou Branch), Zhejiang Province 312400, China
| | - Jianjiang Huang
- Critical Care Medicine, Shengzhou People's Hospital (The First Affiliated Hospital of Zhejiang University Shengzhou Branch), Zhejiang Province 312400, China
| | - Jie Yang
- Critical Care Medicine, Shengzhou People's Hospital (The First Affiliated Hospital of Zhejiang University Shengzhou Branch), Zhejiang Province 312400, China
| | - Yuyu Wang
- Critical Care Medicine, Shengzhou People's Hospital (The First Affiliated Hospital of Zhejiang University Shengzhou Branch), Zhejiang Province 312400, China
| | - Bin Qiu
- Critical Care Medicine, Shengzhou People's Hospital (The First Affiliated Hospital of Zhejiang University Shengzhou Branch), Zhejiang Province 312400, China
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Ullah S, Yang BH, Liu D, Lu XY, Liu ZZ, Zhao LX, Zhang JY, Liu BR. Are laparoscopic cholecystectomy and natural orifice transluminal endoscopic surgery gallbladder preserving cholecystolithotomy truly comparable? A propensity matched study. World J Gastrointest Surg 2022; 14:470-481. [PMID: 35734621 PMCID: PMC9160690 DOI: 10.4240/wjgs.v14.i5.470] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 01/18/2022] [Accepted: 04/09/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cholecystectomy is the preferred treatment option for symptomatic gallstones. However, another option is gallbladder-preserving cholecystolithotomy which preserves the normal physiological functions of the gallbladder in patients desiring to avoid surgical resection. AIM To compare the feasibility, safety and effectiveness of pure natural orifice transluminal endoscopic surgery (NOTES) gallbladder-preserving cholecystolithotomy vs laparoscopic cholecystectomy (LC) for symptomatic gallstones. METHODS We adopted propensity score matching (1:1) to compare trans-rectal NOTES cholecystolithotomy and LC patients with symptomatic gallstones. We reviewed 2511 patients with symptomatic gallstones from December 2017 to December 2020; 517 patients met the matching criteria (NOTES, 110; LC, 407), yielding 86 pairs. RESULTS The technical success rate for the NOTES group was 98.9% vs 100% for the LC group. The median procedure time was 119 min [interquartile ranges (IQRs), 95-175] with NOTES vs 60 min (IQRs, 48-90) with LC (P < 0.001). The frequency of post-operative pain was similar between NOTES and LC: 4.7% (4/85) vs 5.8% (5/95) (P = 0.740). The median duration of post-procedure fasting with NOTES was 1 d (IQRs, 1-2) vs 2 d with LC (IQRs, 1-3) (P < 0.001). The median post-operative hospital stay for NOTES was 4 d (IQRs, 3-6) vs 4 d for LC (IQRs, 3-5), (P = 0.092). During follow-up, diarrhea was significantly less with NOTES (5.8%) compared to LC (18.6%) (P = 0.011). Gallstones and cholecystitis recurrence within a median of 12 mo (range: 6-40 mo) following NOTES was 10.5% and 3.5%, respectively. Concerns regarding the presence of abdominal wall scars were present in 17.4% (n = 15/86) of patients following LC (mainly women). CONCLUSION NOTES provides a feasible new alternative scar-free treatment for patients who are unwilling or unable to undergo cholecystectomy. This minimally invasive organ-sparing procedure both removes the gallstones and preserves the physiological function of the gallbladder. Reducing gallstone recurrence is essential to achieving widespread clinical adoption of NOTES.
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Affiliation(s)
- Saif Ullah
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
| | - Bao-Hong Yang
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
- Department of Oncology, Weifang People's Hospital, Weifang 261000, Shandong Province, China
| | - Dan Liu
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
| | - Xue-Yang Lu
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
| | - Zhen-Zhen Liu
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
| | - Li-Xia Zhao
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
| | - Ji-Yu Zhang
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
| | - Bing-Rong Liu
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
- State Key Laboratory of Esophageal Cancer Prevention and Treatment, Zhengzhou University, Zhengzhou 450052, Henan Province, China
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Liao Y, Cai Q, Zhang X, Li F. Single-stage intraoperative ERCP combined with laparoscopic cholecystectomy versus preoperative ERCP Followed by laparoscopic cholecystectomy in the management of cholecystocholedocholithiasis: A meta-analysis of randomized trials. Medicine (Baltimore) 2022; 101:e29002. [PMID: 35451394 PMCID: PMC8913127 DOI: 10.1097/md.0000000000029002] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 01/04/2022] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES The optimal treatment strategy for cholecystocholedocholithiasis is still controversial. We conducted an up-to-date meta-analysis to compare the efficacy and safety of the intra- endoscopic retrograde cholangiopancreatography (ERCP) + LC procedure with the traditional pre-ERCP + laparoscopic cholecystectomy (LC) procedure in the management of cholecystocholedocholithiasis. METHODS We searched the PubMed, Embase, Cochrane Library, and Web of Science databases up to September 2020. Published randomized controlled trials comparing intra-ERCP + LC and pre-ERCP + LC were considered. This meta-analysis was performed by Review Manager Version 5.3, and outcomes were documented by pooled risk ratio (RR) and mean difference (MD) with 95% confidence intervals. RESULTS Eight studies with a total of 977 patients were included in this meta-analysis. There was no significant difference between the two groups regarding CBD stone clearance (RR = 1.03, P = .27), postoperative papilla bleeding (RR = 0.41, P = .13), postoperative cholangitis (RR = 0.87, P = .79), and operation conversion rate (RR = 0.71, P = .26). The length of hospital stay was shorter in the intra-ERCP + LC group (MD = -2.75, P < .05), and intra-ERCP + LC was associated with lower overall morbidity (RR = 0.54, P < .05), postoperative pancreatitis (RR = 0.29, P < .05) and cannulation failure rate (RR = 0.22, P < .05). CONCLUSIONS Intra-ERCP + LC was a safer approach for patients with cholecystocholedocholithiasis. It could facilitate intubation, shorten hospital stay, and lower postoperative complications, especially postoperative pancreatitis, and reduce stone residue and reduce the possibility of reoperation for stone removal.
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Affiliation(s)
- Yang Liao
- Department of Hepatobiliary Surgery, Zigong First People's Hospital, Zigong, Sichuan, China
| | - Qichen Cai
- Department of Hepatobiliary Surgery, Chengdu Second People's Hospital, Sichuan, China
| | - Xiaozhou Zhang
- Department of Hepatobiliary Surgery, Zigong First People's Hospital, Zigong, Sichuan, China
| | - Fugui Li
- Department of Hepatobiliary Surgery, Zigong First People's Hospital, Zigong, Sichuan, China
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Hao M, Dou Z, Xu L, Shao Z, Sun H, Li Z. RNA Sequencing Analysis of Gene Expression by Electroacupuncture in Guinea Pig Gallstone Models. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:3793946. [PMID: 35035504 PMCID: PMC8759925 DOI: 10.1155/2022/3793946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 12/14/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Clinical studies have shown that electroacupuncture (EA) promotes gallbladder motility and alleviates gallstone. However, the mechanism underlying the effects of EA on gallstone is poorly understood. In this study, the mRNA transcriptome analysis was used to study the possible therapeutic targets of EA. METHODS Hartley SPF guinea pigs were employed for the gallstone models. Illumina NovaSeq 6000 platform was used for the RNA sequencing of guinea pig gallbladders in the normal group (Normal), gallstone model group (Model), and EA-treated group (EA). Differently expressed genes (DEGs) were examined separately in Model vs. Normal and EA vs. Model. DEGs reversed by EA were selected by comparing the DEGs of Model vs. Normal and EA vs. Model. Biological functions were enriched by gene ontology (GO) analysis. The protein-protein interaction (PPI) network was analyzed. RESULTS After 2 weeks of EA, 257 DEGs in Model vs. Normal and 1704 DEGs in EA vs. Model were identified. 94 DEGs reversed by EA were identified among these DEGs, including 28 reversed upregulated DEGs and 66 reversed downregulated DEGs. By PPI network analysis, 10 hub genes were found by Cytohubba plugin of Cytoscape. Quantitative real-time PCR (qRT-PCR) verified the changes. CONCLUSION We identified a few GOs and genes that might play key roles in the treatment of gallstone. This study may help understand the therapeutic mechanism of EA for gallstone.
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Affiliation(s)
- Mingyao Hao
- External Treatment Center of Traditional Chinese Medicine, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250014, China
| | - Zhiqiang Dou
- College of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
| | - Luyao Xu
- College of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
| | - Zongchen Shao
- College of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
| | - Hongwei Sun
- Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
| | - Zhaofeng Li
- College of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
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10
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Alshehri AO, Aljuhani TS, Alotaibi SS, Almughamisi SA, Ageel MM, Alameer AH, Alqahtani KM, Alhumaid ZA, Alsuwayeh AS, Almarri MS, Almotadaris SF, Alsaeed HY, Alatwai AM, Alatawi AM, Al-Hawaj F. Colonic Gallstone Ileus: A Rare Etiology of Large Bowel Obstruction. Cureus 2021; 13:e20338. [PMID: 35036183 PMCID: PMC8752347 DOI: 10.7759/cureus.20338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2021] [Indexed: 11/05/2022] Open
Abstract
Large bowel obstruction is a surgical emergency that requires prompt diagnosis and management. It is frequently caused by colon cancer. However, the common benign etiologies include volvulus, hernia, adhesions, and strictures. Imaging studies are essential to establish the diagnosis and identify the etiology. We present the case of a 44-year-old female who presented to the emergency department with abdominal pain and distension for a one-week duration. The pain was associated with decreased bowel motions and vomiting. Her past medical history was significant for diabetes mellitus, dyslipidemia, polycystic ovarian syndrome, and recurrent episodes of biliary colic. Upon examination, she had tachycardia, normal temperature, and normal blood pressure. Abdominal examination revealed a distended abdomen with generalized tenderness and increased intensity of bowel sounds. The laboratory markers were noncontributory. Abdominal computed tomography (CT) scan of the abdomen with intravenous contrast demonstrated the presence of an oval-shaped hypodense intraluminal mass in the sigmoid colon where there was a transition point with proximal colonic dilatation. There was an abnormal communication between the gallbladder and the colon at the hepatic flexure, representing a cholecystocolic fistula tract. This represents a mechanical obstruction of the large bowel due to migrated gallstone through a cholecystocolic fistula tract. The patient was prepared for an emergency laparotomy. The gallstone was removed, and the sigmoid colon was sutured primarily. Resection of the gallbladder was made with the closure of the fistula tract. Following the surgery, the patient reported a resolution of her abdominal pain. Oral feeding was started gradually. After six months of close follow-up, the patient remained asymptomatic with no new complaints. Cholecystocolic fistula is a very rare complication of gallbladder disease. Despite its rarity, surgeons should remember this etiology of large intestinal obstruction when they encounter a patient with gallbladder disease.
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Affiliation(s)
| | | | | | | | - Mariam M Ageel
- College of Medicine, King Abdulaziz University, Jeddah, SAU
| | | | | | - Ziyad A Alhumaid
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | | | | | | | | | - Abdallh M Alatwai
- College of Medicine, Jordan University of Science and Technology, Irbid, SAU
| | | | - Faisal Al-Hawaj
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU
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11
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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.
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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.
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12
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Pang Y, Lv J, Kartsonaki C, Guo Y, Yu C, Chen Y, Yang L, Bian Z, Millwood IY, Walters RG, Li X, Zou J, Holmes MV, Chen J, Chen Z, Li L. Causal effects of gallstone disease on risk of gastrointestinal cancer in Chinese. Br J Cancer 2021; 124:1864-1872. [PMID: 33772150 PMCID: PMC8144569 DOI: 10.1038/s41416-021-01325-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 02/05/2021] [Accepted: 02/19/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Gallstone disease (GSD) is associated with a higher risk of gastrointestinal (GI) cancer. However, it is unclear whether the associations are causal. METHODS The prospective China Kadoorie Biobank (CKB) recorded 17,598 cases of GI cancer among 510,137 participants without cancer at baseline during 10 years of follow-up. Cox regression was used to estimate hazard ratios (HRs) for specific cancer by GSD status and duration. Mendelian randomisation was conducted to assess the genetic associations of GSD with specific cancer. RESULTS Overall 6% of participants had symptomatic GSD at baseline. Compared with those without GSD, individuals with symptomatic GSD had adjusted HRs of 1.13 (1.01-1.29) for colorectal, 2.01 (1.78-2.26) for liver, 3.70 (2.88-4.87) for gallbladder, 2.31 (1.78-3.07) for biliary tract, and 1.38 (1.18-1.74) for pancreatic cancer. Compared with participants without GSD, the risks of colorectal, liver, gallbladder, biliary tract, and pancreatic cancer were highest during 0 to <5 years following disease diagnosis. There was evidence of genetic associations of GSD with these cancers, with odds ratios per 1-SD genetic score of 1.08 (1.05-1.11) for colorectal, 1.22 (1.19-1.25) for liver, 1.56 (1.49-1.64) for gallbladder, 1.39 (1.31-1.46) for biliary tract, and 1.16 (1.10-1.22) for pancreatic cancer. When meta-analysing the genetic estimates in CKB and UK Biobank, there was evidence of causal associations of GSD with colon cancer, gallbladder and biliary tract cancer (GBTC), and total GI cancer (RR per 1-SD: 1.05 [0.99-1.11], 2.00 [1.91-2.09], and 1.09 [1.05-1.13]). CONCLUSIONS GSD was associated with higher risks of several GI cancers, warranting future studies on the underlying mechanisms.
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Affiliation(s)
- Yuanjie Pang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response (PKU-PHEPR), Peking University, 38 Xueyuan Road, Beijing, 100191, China
| | - Christiana Kartsonaki
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, Big Data Institute Building, Roosevelt Drive, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit (MRC PHRU) at the University of Oxford, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response (PKU-PHEPR), Peking University, 38 Xueyuan Road, Beijing, 100191, China
| | - Yiping Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, Big Data Institute Building, Roosevelt Drive, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit (MRC PHRU) at the University of Oxford, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Ling Yang
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, Big Data Institute Building, Roosevelt Drive, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit (MRC PHRU) at the University of Oxford, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Beijing, China
| | - Iona Y Millwood
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, Big Data Institute Building, Roosevelt Drive, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit (MRC PHRU) at the University of Oxford, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Robin G Walters
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, Big Data Institute Building, Roosevelt Drive, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit (MRC PHRU) at the University of Oxford, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Xiaojun Li
- Jili Street Community Health Service Center, Liuyang, China
| | - Ju Zou
- Jili Street Community Health Service Center, Liuyang, China
| | - Michael V Holmes
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, Big Data Institute Building, Roosevelt Drive, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit (MRC PHRU) at the University of Oxford, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospital, Oxford, UK
| | - Junshi Chen
- National Center for Food Safety Risk Assessment, Beijing, China
| | - Zhengming Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, Big Data Institute Building, Roosevelt Drive, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit (MRC PHRU) at the University of Oxford, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing, China.
- Peking University Center for Public Health and Epidemic Preparedness & Response (PKU-PHEPR), Peking University, 38 Xueyuan Road, Beijing, 100191, China.
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13
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Migda B, Gabryelczak MA, Migda A, Prostacka K. A rare complication of cholecystolithiasis: perforation of the gallbladder. J Ultrason 2021; 21:63-66. [PMID: 33791117 PMCID: PMC8008203 DOI: 10.15557/jou.2021.0009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 11/30/2020] [Indexed: 01/06/2023] Open
Abstract
Common complications of cholelithiasis include gallbladder inflammation, cholangitis, and acute pancreatitis. On the other hand, rare complications include gallbladder carcinoma, gallstone ileus, Mirizzi syndrome and gallbladder perforation. Some patients with cholecystitis do not require hospitalization. It is of key importance for proper further diagnosis and treatment to remember about the possible complications of cholecystitis, especially in oligosymptomatic patients. Therefore, ultrasound examinations in patients with a history of gallbladder stones should be performed with appropriate care. Ultrasound should be performed carefully in patients with a history of cholecystolithiasis, especially those oligosymptomatic, bearing in mind that there are some rare complications of this highly common clinical entity.
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Affiliation(s)
- Bartosz Migda
- Ultrasound Department, Medical University of Warsaw, Brodnowski Hostpial, Poland
| | | | - Anna Migda
- Department of Internal Medicine, Endocrinology and Diabetology, Medical University of Warsaw, Masovian Brodnowski Hostpial, Warsaw, Poland
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14
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SILODIA A, BAGHEL A, SAYTODE VP, DADORIYA AS, DWIVEDI G, SHARMA D, YADAV SK. An unexpected cause of acute pancreatitis: postcholecystectomy cystic duct stump stone. Chirurgia (Bucur) 2021. [DOI: 10.23736/s0394-9508.20.05127-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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15
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Zhong G, Luo Y, Chi Z, Zhang Y, Xu W, Zhu D, Li J, Hu X, Jiao L. Clinical acupuncture therapy for chronic cholecystitis: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e24994. [PMID: 33725874 PMCID: PMC7969282 DOI: 10.1097/md.0000000000024994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 02/11/2021] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT Chronic cholecystitis is a common chronic disease in clinical practice. The incidence of chronic cholecystitis is gradually increasing due to changes in eating habits and even if acute infections aren't treated in time, it can cause serious complications, continue to plague people's daily life and become an economic burden to society. Currently, the curative effect of chronic cholecystitis under the control of western medicine is still lacking and there are adverse reactions. However, based on current clinical controlled trials acupuncture therapy for chronic cholecystitis has gradually become a complementary treatment. Therefore, this systematic review aims to explore the safety and feasibility of acupuncture therapy in the treatment of chronic cholecystitis. METHODS We will search the following databases: Medline, PubMed, Cochrane Database of Systematic Reviews, Embase, Chinese Biomedical Literatures Database, China National Knowledge Infrastructure, Wang Fang Database, Chinese Scientific Journal Database from inception to February 2021 without any language restriction. At the same time, relevant literature will be searched manually. The main search terms include: "Acupuncture," "Cholecystitis." Data entry will be completed by 2 researchers separately. After entry, cross-checking will be performed to ensure the authenticity of the information. The main outcome criteria include: including the total effective rate of the patient; the traditional Chinese medicine symptom score of the patient includes: abdominal pain, tenderness in the right upper abdomen, and so on; secondary outcome criteria include: gallbladder contraction function and gallbladder thickness, VAS scores, recurrence rate, adverse reactions; use Cochrane risk bias assessment to evaluate and score the included randomized controlled trial; meta-analysis will be performed using RevMan 5.4.0 software. The heterogeneity test is based on the thresholds of P and I2, In order to use solid or random effects models. RESULTS This systematic review only evaluates the safety and limitations of acupuncture therapy in the treatment of chronic cholecystitis. We will report the full text in the near future. CONCLUSION This study will explore the safety and limitations of acupuncture therapy in the treatment of chronic cholecystitis, so that acupuncture therapy will be more widely used clinically. TRIAL REGISTRATION NUMBER INPLASY202120020.
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Affiliation(s)
- Genping Zhong
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang
| | - Yinghua Luo
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang
| | - Zhenhai Chi
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang
| | - Yunxiu Zhang
- Central Health Center of Juncun Township, Xingguo County
| | - Wei Xu
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang
| | - DaoCheng Zhu
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang
| | - Jun Li
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang
| | - Xingyao Hu
- Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Lin Jiao
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang
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16
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Pang Y, Kartsonaki C, Lv J, Millwood IY, Yu C, Guo Y, Chen Y, Bian Z, Yang L, Chen J, Clarke R, Walters R, Wu S, Li H, Holmes MV, Li L, Chen Z. Observational and Genetic Associations of Body Mass Index and Hepatobiliary Diseases in a Relatively Lean Chinese Population. JAMA Netw Open 2020; 3:e2018721. [PMID: 33006619 PMCID: PMC7532388 DOI: 10.1001/jamanetworkopen.2020.18721] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
IMPORTANCE There is some support for the existence of genetic associations between adiposity and certain hepatobiliary diseases in Western populations. However, there is little evidence of such genetic associations in China, where the causes of these diseases may differ from those in Western populations and the mean body mass index (BMI) is much lower. OBJECTIVES To compare the observational associations of BMI with hepatobiliary diseases and liver biomarkers with the genetic associations between BMI and these factors and to assess whether the genetic associations of BMI with liver diseases differed by hepatitis B virus infection status. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from the prospective China Kadoorie Biobank, including 473 938 adults aged 30 to 79 years without hepatobiliary diseases at baseline from 10 diverse areas in China from June 25, 2004, to July 15, 2008. A random sample of 75 736 participants with genotyping data was included in the Mendelian randomization analysis. Follow-up was completed January 1, 2017 (median [interquartile range] length of follow-up, 10.2 [9.2-11.1] years). Data were analyzed from January to October 2019. EXPOSURES Measured BMI obtained during the baseline survey and genetically instrumented BMI derived using 92 single-nucleotide variations. MAIN OUTCOMES AND MEASURES Incident cases of hepatobiliary diseases, liver enzymes, fatty liver index, and fibrosis score. RESULTS Among 473 938 individuals (276 041 [58.2%] women), the mean (SD) age was 52 (10.9) years and mean (SD) BMI was 23.8 (3.4). Baseline BMI was associated with higher risks of chronic liver disease (adjusted risk ratio per 1-SD increase, 1.14; 95% CI, 1.11 to 1.17) and gallbladder disease (adjusted risk ratio per 1-SD increase, 1.29; 95% CI, 1.27 to 1.31), with heterogeneity by disease subtype (P < .001). Genetically instrumented BMI was associated with higher risks of chronic liver disease (risk ratio per 1-SD increase, 1.55; 95% CI, 1.08 to 2.24) and gallbladder disease (risk ratio per 1-SD increase, 1.40; 95% CI, 1.11 to 1.76), with no heterogeneity between subtypes. A meta-analysis of the genetic associations in China Kadoorie Biobank and those calculated in UK Biobank gave a risk ratio of 1.55 (95% CI, 1.30 to 1.84) for chronic liver disease and 1.42 (95% CI, 1.22 to 1.64) for gallbladder disease. In the China Kadoorie Biobank study, there were positive genetic associations of BMI with liver enzymes, steatosis, and fibrosis scores, consistent with observational associations. The genetic associations of BMI with liver diseases and biomarkers did not differ by hepatitis B virus infection status. CONCLUSIONS AND RELEVANCE In this cohort study of a relatively lean Chinese population, there were positive genetic associations of BMI with hepatobiliary diseases. These results suggest that maintaining a healthy weight through diet and physical activity may help prevent hepatobiliary diseases.
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Affiliation(s)
- Yuanjie Pang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Christiana Kartsonaki
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, Big Data Institute University of Oxford, Oxford, United Kingdom
- Medical Research Council Population Health Research Unit at the University of Oxford, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Iona Y. Millwood
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, Big Data Institute University of Oxford, Oxford, United Kingdom
- Medical Research Council Population Health Research Unit at the University of Oxford, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, China
| | - Yiping Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, Big Data Institute University of Oxford, Oxford, United Kingdom
- Medical Research Council Population Health Research Unit at the University of Oxford, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Beijing, China
| | - Ling Yang
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, Big Data Institute University of Oxford, Oxford, United Kingdom
- Medical Research Council Population Health Research Unit at the University of Oxford, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing, China
| | - Robert Clarke
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, Big Data Institute University of Oxford, Oxford, United Kingdom
| | - Robin Walters
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, Big Data Institute University of Oxford, Oxford, United Kingdom
- Medical Research Council Population Health Research Unit at the University of Oxford, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Shukuan Wu
- Haikou Meilan Disease Prevention and Control Center, Haikou, China
| | - Huimei Li
- Haikou Meilan Disease Prevention and Control Center, Haikou, China
| | - Michael V. Holmes
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, Big Data Institute University of Oxford, Oxford, United Kingdom
- Medical Research Council Population Health Research Unit at the University of Oxford, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospitals National Health Service Foundation Trust, Oxford, United Kingdom
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, Big Data Institute University of Oxford, Oxford, United Kingdom
- Medical Research Council Population Health Research Unit at the University of Oxford, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
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17
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Surgical Techniques for the Laparoscopic Treatment of Bile Duct Stones in Patients With a History of Upper Abdominal Operations: Retrospective Cohort Study. Surg Laparosc Endosc Percutan Tech 2020; 29:503-508. [PMID: 31800398 DOI: 10.1097/sle.0000000000000678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE Few authors have studied applying the laparoscopic approach in patients with previous upper abdominal operations, but no comparison has been made between laparoscopic and open approaches in patients with previous upper abdominal operations. This article aims to introduce surgical techniques and details in treatment to surgeons specialized in minimally invasive surgery. MATERIALS AND METHODS From January 2010 to January 2018, 460 eligible patients were divided into 3 groups and analyzed retrospectively. Group A: patients with a history of upper abdominal operations who underwent laparoscopy (n=124); group B: patients without a history of upper abdominal operations who underwent laparoscopy (n=140); and group C: patients with a history of upper abdominal operations who underwent an open operation (n=196). Group A was the experimental group; groups B and C served as the control groups. RESULTS No significant difference was found between groups A and B. Significant differences were found between groups A and C in estimated blood loss (258.3±67.2 vs. 424.7±103.7 mL, P<0.001), postoperative hospitalization (5.7±2.3 vs. 10.2±3.1 d, P<0.001), and postoperative complications (16.1% vs. 42.9%, P=0.013). The final rate of stones clearance was 100% in 3 groups. The total rate of stone recurrence was 7.8%. CONCLUSIONS Laparoscopy with certain surgical techniques was feasible, effective, and advantageous for patients with previous upper abdominal operations by experienced surgeons. It is necessary for surgeons to have advanced skills and surgical techniques to achieve a successful laparoscopy.
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Wang J, Shen S, Wang B, Ni X, Liu H, Ni X, Yu R, Suo T, Liu H. Serum lipid levels are the risk factors of gallbladder stones: a population-based study in China. Lipids Health Dis 2020; 19:50. [PMID: 32192520 PMCID: PMC7083041 DOI: 10.1186/s12944-019-1184-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 12/30/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Gallstones are the cause of a majority of biliary tract discomfort. Although many community-based studies have addressed the risk factors for gallstone disease (GSD), little is known about GSD prevalence and risk factors in Chinese populations. METHODS From January 2014 to January 2015, participants (N = 2,068,523) were recruited by Meinian Onehealth Healthcare Co., Ltd. They received a physical examination, and GSD was determined by ultrasound. RESULTS The prevalence of GSD was 8.1%. Risks of GSD were similar between males and females in all age groups. Risk factors for gallstones include body mass index, waist circumference, waist-to-hip ratio, and physical activity, as well as biological factors such as age, sex, and elevated blood lipid levels. Serum lipid levels of GSD were statistically different from controls in total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (H-DL), low-density lipoprotein cholesterol (LDL), and apolipoprotein B (APOB). Furthermore, TC > 5.00 mmol/L, TG > 1.39 mmol/L, HDL < 1.19 mmol/L, LDL > 3.04 mmol/L, and APOB > 0.97 mmol/L were risk factors for gallstones. CONCLUSIONS Serum lipid levels are associated with GSD. TC, TG, LDL, and APOB are risk factors, while HDL is a protective factor.
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Affiliation(s)
- Jiwen Wang
- Department of General Surgery, Zhongshan Hospital, General Surgery Institute, Fudan University, No. 180 Fenglin Rd, Shanghai, 200032, China
- Meinian Onehealth Healthcare Holding Co., Ltd, Shanghai, 200030, China
| | - Sheng Shen
- Department of General Surgery, Zhongshan Hospital, General Surgery Institute, Fudan University, No. 180 Fenglin Rd, Shanghai, 200032, China
- Meinian Onehealth Healthcare Holding Co., Ltd, Shanghai, 200030, China
| | - Bo Wang
- Biliary Tract Disease Institute, Fudan University, Shanghai, 200032, China
| | - Xiaojian Ni
- Department of General Surgery, Zhongshan Hospital, General Surgery Institute, Fudan University, No. 180 Fenglin Rd, Shanghai, 200032, China
- Meinian Onehealth Healthcare Holding Co., Ltd, Shanghai, 200030, China
| | - Han Liu
- Department of General Surgery, Zhongshan Hospital, General Surgery Institute, Fudan University, No. 180 Fenglin Rd, Shanghai, 200032, China
- Meinian Onehealth Healthcare Holding Co., Ltd, Shanghai, 200030, China
| | - Xiaoling Ni
- Department of General Surgery, Zhongshan Hospital, General Surgery Institute, Fudan University, No. 180 Fenglin Rd, Shanghai, 200032, China
- Meinian Onehealth Healthcare Holding Co., Ltd, Shanghai, 200030, China
| | - Rong Yu
- Biliary Tract Disease Institute, Fudan University, Shanghai, 200032, China
| | - Tao Suo
- Department of General Surgery, Zhongshan Hospital, General Surgery Institute, Fudan University, No. 180 Fenglin Rd, Shanghai, 200032, China.
- Meinian Onehealth Healthcare Holding Co., Ltd, Shanghai, 200030, China.
| | - Houbao Liu
- Department of General Surgery, Zhongshan Hospital, General Surgery Institute, Fudan University, No. 180 Fenglin Rd, Shanghai, 200032, China.
- Meinian Onehealth Healthcare Holding Co., Ltd, Shanghai, 200030, China.
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Jia Z, Peng J, Wan X, He P, Luo D. Endoscopic minimally invasive cholecystolithotomy in a patient with duplicate gallbladder: a case report. J Int Med Res 2019; 48:300060519886973. [PMID: 31878802 PMCID: PMC7607051 DOI: 10.1177/0300060519886973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Gallstone disease is common in China and is generally treated with laparoscopic cholecystectomy. For some patients with normal contraction function and a small number of stones, endoscopic minimally invasive cholecystolithotomy is an additional possible treatment method that avoids complications related to laparoscopic cholecystectomy. Here, we describe a 45-year-old woman who underwent endoscopic minimally invasive cholecystolithotomy and was found to have duplicate gallbladder, which was not diagnosed preoperatively. We discuss the usefulness of the endoscopic minimally invasive cholecystolithotomy procedure and the management of duplicate gallbladder in patients undergoing endoscopic minimally invasive cholecystolithotomy.
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Affiliation(s)
- Zeming Jia
- Hepatobiliary and Enteric Surgery Research Center of Xiangya Hospital, Central South University, Changsha, P.R. China
| | - Jian Peng
- Hepatobiliary and Enteric Surgery Research Center of Xiangya Hospital, Central South University, Changsha, P.R. China
| | - Xiaoping Wan
- Hepatobiliary and Enteric Surgery Research Center of Xiangya Hospital, Central South University, Changsha, P.R. China
| | - Panxiang He
- Hepatobiliary and Enteric Surgery Research Center of Xiangya Hospital, Central South University, Changsha, P.R. China
| | - Dongren Luo
- Hepatobiliary and Enteric Surgery Research Center of Xiangya Hospital, Central South University, Changsha, P.R. China
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Wang F, Wang J, Li Y, Yuan J, Yao P, Wei S, Guo H, Zhang X, Yang H, Wu T, He M. Gallstone Disease and Type 2 Diabetes Risk: A Mendelian Randomization Study. Hepatology 2019; 70:610-620. [PMID: 30515881 DOI: 10.1002/hep.30403] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 11/23/2018] [Indexed: 12/21/2022]
Abstract
The presence of gallstone disease (GSD) was reported to be positively associated with diabetes risk. Whether the association is causal remains unclear. We aim to examine the potential causal association between GSD and type 2 diabetes risk using a Mendelian randomization analysis. Observational study was conducted among 16,299 participants who were free of cancer, heart disease, stroke, and diabetes at baseline in the Dongfeng-Tongji cohort study. GSD was diagnosed by experienced physicians by abdominal B-type ultrasound inspection and type 2 diabetes was defined according to the criteria of the American Diabetes Association. Cox proportional hazard regression model was used to examine the association of GSD with type 2 diabetes risk. A genetic risk score (GRS) for GSD was constructed with eight single nucleotide polymorphisms that were derived from the previous genome-wide association studies. The causal associations of the score for GSD with type 2 diabetes were tested among 7,000 participants in Mendelian randomization analysis. We documented 1,110 incident type 2 diabetes cases during 73,895 person-years of follow-up from 2008 to 2013 (median 4.6 years). Compared with participants without GSD, the multivariate-adjusted hazard ratio of type 2 diabetes risk in those with GSD was 1.22 (95% confidence interval [CI], 1.03-1.45, P = 0.02). Each 1 SD (0.23) increment in the weighted GRS was associated with a 17% increment of type 2 diabetes risk (odds ratio = 1.17, 95% CI, 0.90-1.52) without statistical significance (P = 0.25). Conclusion: The present study supported a positive but not a causal association of GSD with type 2 diabetes risk. More studies are needed to verify our findings.
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Affiliation(s)
- Fei Wang
- Department of Occupational and Environmental Health and Key Laboratory of Environmental and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Jing Wang
- Department of Occupational and Environmental Health and Key Laboratory of Environmental and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Yaru Li
- Department of Occupational and Environmental Health and Key Laboratory of Environmental and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Jing Yuan
- Department of Occupational and Environmental Health and Key Laboratory of Environmental and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Ping Yao
- Department of Occupational and Environmental Health and Key Laboratory of Environmental and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Sheng Wei
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Huan Guo
- Department of Occupational and Environmental Health and Key Laboratory of Environmental and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Xiaomin Zhang
- Department of Occupational and Environmental Health and Key Laboratory of Environmental and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Handong Yang
- Dongfeng Central Hospital, Dongfeng Motor Corporation and Hubei University of Medicine, Shiyan, Hubei, P.R. China
| | - Tangchun Wu
- Department of Occupational and Environmental Health and Key Laboratory of Environmental and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Meian He
- Department of Occupational and Environmental Health and Key Laboratory of Environmental and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
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Abstract
Gallstone disease is caused by multiple pathogenic factors and is common worldwide. Most studies have focused on the significance of the biliary microbiome in gallstone pathogenesis. Areas covered: In this study, the epidemiology of gallstone diseases and the existence, composition, origin, and mechanisms of the biliary microbiota were reviewed. Mechanisms involved in promoting the formation of different types of gallstones were also emphasized. The antibiotic susceptibility of the biliary microbiota is briefly discussed because it may guide clinical strategies. Expert commentary: The biliary microbiome facilitates the formation of brown pigment stones. Although glycoprotein (mucin) may be pivotal for many promoting substances to coagulate and integrate relevant components, new mechanisms involving prostaglandins, oxysterols, oxygen free radicals, and lipopolysaccharides have been discovered. Furthermore, specific bacterial species such as Helicobacter and Salmonella are involved in the pathogenesis of cholesterol gallstones. Recently, metabolomics of the biliary microbiome has been used to determine the detailed mechanisms that promote gallstone formation. Previously, the bacterial effects involved in the pathogenesis of brown pigment stones have not been analyzed in detail. Whether the administration of antibiotics is related to prophylaxis for gallstone formation and gallstone-associated infections remains unclear.
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Affiliation(s)
- Yining Wang
- a Department of Gastroenterology , The First Affiliated Hospital of Nanchang University , Nanchang, Jiangxi , China.,b Joint Programme of Nanchang University and Queen Mary University of London , Nanchang , China
| | - Miao Qi
- a Department of Gastroenterology , The First Affiliated Hospital of Nanchang University , Nanchang, Jiangxi , China.,b Joint Programme of Nanchang University and Queen Mary University of London , Nanchang , China
| | - Cheng Qin
- a Department of Gastroenterology , The First Affiliated Hospital of Nanchang University , Nanchang, Jiangxi , China.,b Joint Programme of Nanchang University and Queen Mary University of London , Nanchang , China
| | - Junbo Hong
- a Department of Gastroenterology , The First Affiliated Hospital of Nanchang University , Nanchang, Jiangxi , China
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Wijarnpreecha K, Thongprayoon C, Panjawatanan P, Manatsathit W, Ungprasert P. Hepatitis B virus infection and risk of gallstones: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol 2016; 28:1437-1442. [PMID: 27648485 DOI: 10.1097/meg.0000000000000754] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND/OBJECTIVES Gallstone disease and its complications are common, particularly in Western populations. Recent studies have reported a significantly increased risk of gallstones among hepatitis C virus-infected patients. However, the data on patients with hepatitis B virus (HBV) infection are still limited. This meta-analysis was carried out with the aim of summarizing all available evidence. PATIENTS AND METHODS A literature search was performed using MEDLINE and the EMBASE database from inception to May 2016. Studies that reported relative risks, odd ratios, or hazard ratios comparing the risk of gallstones among HBV-infected patients versus patients without HBV infection were included. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse-variance method. RESULTS Nine studies fulfilled our eligibility criteria and were included in the analysis. We found no significant association between HBV infection and the risk of gallstones, with a pooled OR of 1.10 (95% CI, 0.91-1.33). The statistical heterogeneity was moderate, with an I of 69%. Subgroup analysis was carried out. The pooled OR of cross-sectional studies was 1.01 (95% CI, 0.91-1.12; I 0%), whereas the pooled OR of case-control studies was 1.53 (95% CI, 0.85-2.74; I 80%). CONCLUSION A significant association between HBV infection and the risk of gallstones was not observed in this study.
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Affiliation(s)
- Karn Wijarnpreecha
- aDepartment of Internal Medicine, Bassett Medical Center, Cooperstown, New York bDepartment of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, Nebraska cDivision of Rheumatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA dDepartment of Biochemistry, Faculty of Medicine, Chiang Mai University, Chiang Mai eDivision of Rheumatology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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The association between gallstones and metabolic syndrome in urban Han Chinese: a longitudinal cohort study. Sci Rep 2016; 6:29937. [PMID: 27443986 PMCID: PMC4957232 DOI: 10.1038/srep29937] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 06/27/2016] [Indexed: 12/11/2022] Open
Abstract
The precise association between metabolic syndrome (MetS) and gallstone disease remains unclear in China. This study aimed to clarify the relationship between MetS and gallstone and evaluate whether counts of metabolic abnormalities had influence on gallstone disease. We fitted gender-specific generalized estimating equation (GEE) regression models with data from a large-scale longitudinal study over 6-year follow-up to elucidate the real association. This study included 18291 participants with 3 times repeated measures at least who were free from a prior history of gallstone disease and cholecystectomy. A total of 873 cases of gallstones occurred during 6-year follow-up. The incidence density of gallstone in the group of subjects with MetS was higher than the group without MetS (10.27 vs 5.79). The GEE analyses confirmed and clarified the association between MetS and gallstone disease in males (RR = 1.33, P = 0.0020), while this association was not significant in females (RR = 1.15, P = 0.4962). With numbers of metabolic syndrome components increasing, the risk of gallstone disease showed corresponding increasing in males. In conclusion, the associations of MetS and gallstone are different in males and in females. And the risk of gallstone disease increases with the number of components of MetS for males but not for females.
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Zhang DM, Wang X, Xue HD, Jin ZY, Sun H, Chen Y, He YL. Determinants of Detection of Stones and Calcifications in the Hepatobiliary System on Virtual Nonenhanced Dual-energy CT. CHINESE MEDICAL SCIENCES JOURNAL = CHUNG-KUO I HSUEH K'O HSUEH TSA CHIH 2016; 31:76-82. [PMID: 28031094 DOI: 10.1016/s1001-9294(16)30029-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Objective To retrospectively determine the features of stones and calcifications in hepatobiliary system on virtual nonenhanced (VNE) dual-energy computed tomography (CT), and to evaluate the possibility of VNE images in diagnosis for those lesions.Methods A total of 128 gall stones and calcifications of the liver found in 110 patients were examined with triple phase abdominal CT scan from July 2007 to December 2011, in which true nonenhanced (TNE) phase and arterial phase were performed with single-energy CT (120 kVp) and portal venous phase was performed with dual-energy CT (100 kVp and 140 kVp). VNE images were generated from the portal venous phase dual-energy CT data sets by using commercially VNC software. The mean CT values for the stone, liver, bile and paraspinal muscle, mean lesion density and size in area dimension, contrast-to-noise ratio (CNR) of lesion to the liver or bile, and image noise were assessed and compared between VNE and TNE images. The effective dose and size-specific dose estimate (SSDE) were also calculated.Results The mean CT values of the lesions measured on VNE images declined significantly compared with those measured on TNE images (164.51±102.13 vs. 290.72±197.80 HU, P<0.001), so did the lesion-to-liver CNR (10.80±11.82 vs.18.81±17.06, P<0.001) and the lesion-to-bile CNR (17.24±14.41 vs. 21.32±17.31, P<0.001). There was no significant difference in size of lesions area between VNE and TNE images (0.69±0.88 vs. 0.72±0.85 cm2, P=0.062). Compared to the 128 lesions found in TNE images, VNE images showed the same density in 30 (23.4%) lesions, lighter density in 88 (68.8%) lesions, while failed to show 10 (7.8%) lesions, and showed the same size in 61 (47.7%) lesions and smaller size in 57 (44.5%) lesions. The CT cutoff values of lesion and size were 229.21 HU and 0.15 cm2, respectively. The total effective dose for triple phase scan protocol with TNE images was 19.51±7.03 mSv, and the SSDE was 39.84±11.10 mGy. The effective dose for dual phase scan protocol with VNE images instead of TNE images was 13.29±4.89 mSv, and the SSDE was 27.83±9.99 mGy. Compared with TNE images, the effective dose and SSDE of VNE images were down by 32.05%±3.69 % and 30.63%±2.34 %, respectively.Conclusions Although the CT values and CNR of the lesions decreased in VNE images, the lesions of which attenuation greater than 229.21 HU and size larger than 0.15 cm2 could be detected with good reliability and obvious dose reduction. There was good consistency in the size of stones and calcifications in hepatobiliary system between VNE images and TNE images, which ensured the possibility of the clinical application of VNE images.
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Peng Y, Yang Y, Liu Y, Nie Y, Xu P, Xia B, Tian F, Sun Q. Cholesterol gallstones and bile host diverse bacterial communities with potential to promote the formation of gallstones. Microb Pathog 2015; 83-84:57-63. [PMID: 25959528 DOI: 10.1016/j.micpath.2015.05.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 05/04/2015] [Accepted: 05/06/2015] [Indexed: 12/31/2022]
Abstract
The prevalence of cholesterol gallstones has increased in recent years. Bacterial infection correlates with the formation of gallstones. We studied the composition and function of bacterial communities in cholesterol gallstones and bile from 22 cholesterol gallstone patients using culture-dependent and culture-independent methods. Altogether fourteen and eight bacterial genera were detected in cholesterol gallstones and bile, respectively. Pseudomonas spp. were the dominant bacteria in both cholesterol gallstones and bile. As judged by diversity indices, hierarchical clustering and principal component analysis, the bacterial communities in gallstones were different from those in bile. The gallstone microbiome was considered more stable than that of bile. The different microbial communities may be partially explained by differences in their habitats. We found that 30% of the culturable strains from cholesterol gallstones secreted β-glucuronidase and phospholipase A2. Pseudomonas aeruginosa strains showed the highest β-glucuronidase activity and produced the highest concentration of phospholipase A2, indicating that Ps. aeruginosa may be a major agent in the formation of cholesterol gallstones.
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Affiliation(s)
- Yuhong Peng
- Key Laboratory of Bio-resource and Bio-environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, Sichuan 610064, PR China
| | - Yang Yang
- Key Laboratory of Bio-resource and Bio-environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, Sichuan 610064, PR China
| | - Yongkang Liu
- The 452nd Hospital of PLA, Chengdu, Sichuan 610000, PR China
| | - Yuanyang Nie
- Key Laboratory of Bio-resource and Bio-environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, Sichuan 610064, PR China
| | - Peilun Xu
- Key Laboratory of Bio-resource and Bio-environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, Sichuan 610064, PR China
| | - Baixue Xia
- Key Laboratory of Bio-resource and Bio-environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, Sichuan 610064, PR China
| | - Fuzhou Tian
- Chengdu Military General Hospital, Chengdu, Sichuan 610083, PR China
| | - Qun Sun
- Key Laboratory of Bio-resource and Bio-environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, Sichuan 610064, PR China.
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Shen TC, Lai HC, Huang YJ, Lin CL, Sung FC, Kao CH. The risk of depression in patients with cholelithiasis before and after cholecystectomy: a population-based cohort study. Medicine (Baltimore) 2015; 94:e631. [PMID: 25761193 PMCID: PMC4602463 DOI: 10.1097/md.0000000000000631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The association between cholelithiasis and depression remains unclear. We examined the risk of depression in patients with cholelithiasis. From the National Health Insurance population claims data of Taiwan, we identified 14071 newly diagnosed cholelithiasis patients (4969 symptomatic and 9102 asymptomatic) from 2000 to 2010. For each cholelithiasis patient, 4 persons without cholelithiasis were randomly selected in the control cohort from the general population frequency matched by age, sex, and diagnosis year. Both cohorts were followed up until the end of 2011 to monitor the occurrence of depression. Adjusted hazard ratios (aHRs) of depression were estimated using the Cox proportional hazards model after controlling for age, sex and comorbidities. The overall incidence rates of depression were 1.87- and 1.83-fold greater in the symptomatic and asymptomatic cholelithiasis subcohorts than in the control cohort (incidence, 10.1 and 9.96 vs 5.43 per 1000 person-years, respectively). The multivariable Cox proportional hazards regression analysis revealed higher variable-specific aHRs in women than in men, in younger patients than in older patients, and in those without comorbidities than in those with any comorbidity. Cholecystectomy reduced the hazard of developing depression with aHRs of 0.79 (95% confidence interval [CI] 0.62-0.99) for symptomatic cholelithiasis patients and 0.76 (95% CI 0.60-0.96) for asymptomatic patients. Patients with cholelithiasis are at a higher risk of developing depression than the general population. Patients could be benefited from cholecystectomy and have the hazard of developing depression significantly reduced.
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Affiliation(s)
- Te-Chun Shen
- From the Graduate Institute of Clinical Medicine Science, College of Medicine, China Medical University (T-CS, H-CL, F-CS, C-HK); Division of Pulmonary and Critical Care Medicine (T-CS); Division of Gastroenterology and Hepatology, Department of Internal Medicine (H-CL); Department of Psychiatry (Y-JH); Management Office for Health Data (C-LL); and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan (C-HK)
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Non-alcoholic fatty liver disease associated with gallstones in females rather than males: a longitudinal cohort study in Chinese urban population. BMC Gastroenterol 2014; 14:213. [PMID: 25496394 PMCID: PMC4273434 DOI: 10.1186/s12876-014-0213-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Accepted: 12/05/2014] [Indexed: 01/06/2023] Open
Abstract
Background Whether non-alcoholic fatty liver disease (NAFLD) is a risk factor for gallstones remains uncertain. Few longitudinal or cohort studies have been used to identify this relationship. The aim of this study was to confirm the association between NAFLD and gallstones in a longitudinal cohort of urban dwellers in China. Methods To elucidate the association between NAFLD and gallstones, we fitted a generalized estimating equation (GEE) model in a large-scale longitudinal cohort over 6 years, which included 11,200 participants with at least three regular health check-ups. Results A total of 498 cases of gallstones occurred during the 6-year follow-up, which resulted in a total incidence density of 12.73 per 1000 person-years (498/39, 135.5 person-years). The GEE analyses confirmed and clarified the association between NAFLD and gallstones (relative risk (RR) = 1.2381, 95% confidence interval (CI) = 1.003–1.528, P = 0.047) after adjusting for other potential confounding factors, especially in females (RR = 1.707, 95% CI = 1.245–2.341, P = 0.001). Conclusions NAFLD is associated with gallstones in an urban Chinese population from the middle to upper socioeconomic strata. Moreover, this association is more strongly apparent in females than in males. Further cohort studies must be conducted to confirm this association in the general population. Electronic supplementary material The online version of this article (doi:10.1186/s12876-014-0213-y) contains supplementary material, which is available to authorized users.
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Yang H, Wang L, Shi YH, Sui GT, Wu YF, Lu XQ, Li MY, Xia Q, Bian XX, Li HH, Qian JM. Risk factors of acute pancreatitis in the elderly Chinese population: a population-based cross-sectional study. J Dig Dis 2014; 15:501-7. [PMID: 24957953 DOI: 10.1111/1751-2980.12168] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Lifestyle changes have led to an increasing incidence of acute pancreatitis (AP) in China. The aims of this study were to evaluate the association between lifestyle as well as medical history and AP in the elderly population and to provide evidence towards the prevention against AP. METHODS A population-based cross-sectional study was conducted in Daqing, Heilongjiang Province, China. A total of 23 294 residents aged ≥55 years were enrolled in the study. A questionnaire survey was conducted to collect data on participants' characteristics, lifestyle and medical history via a face-to-face interview, and compared these data with the medical chart. RESULTS In total, 45 participants had been diagnosed with AP, that is, a prevalence of 0.19%. No significant differences were observed with respect to their age, gender, marital status or body mass index (BMI) in participants with and without AP. However, those were better educated were more likely to develop AP (P = 0.005). The univariate analysis showed that a high meat intake, smoking, alcohol consumption and a medical history of gallstones were associated with a significant increase in the risk of developing AP (P < 0.05). Furthermore, smoking or alcohol consumption was dose-dependently associated with the risk of AP, particularly in those who smoked at least 15 pack-years or consumed ≥56.2 drinks per year. Multivariable logistics analysis suggested that the level of education, smoking and medical history of gallstone are independent risk factors for AP. CONCLUSIONS Our study indicated that a higher education level, smoking, alcohol consumption and history of gallstones may be potential risk factors for AP in the elderly in northeast China.
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Affiliation(s)
- Hong Yang
- Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, School of Basic Medicine, Beijing
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Tan YY, Zhao G, Wang D, Wang JM, Tang JR, Ji ZL. A new strategy of minimally invasive surgery for cholecystolithiasis: calculi removal and gallbladder preservation. Dig Surg 2014; 30:466-71. [PMID: 24481280 DOI: 10.1159/000357823] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 12/07/2013] [Indexed: 12/13/2022]
Abstract
BACKGROUND Cholecystolithiasis is a common disease. Cholecystectomy is the main treatment method but is associated with various complications in some patients. This study explores a novel, minimally invasive surgery for the removal of calculi and the preservation of the gallbladder using a laparoscope combined with the soft choledochoscope. METHOD A retrospective analysis was conducted between January 2010 and December 2012 in 65 patients with cholecystolithiasis who underwent the minimally invasive surgery for calculi removal and gallbladder preservation. RESULTS In 61 cases of gallstone removal, the gallbladder was preserved perfectly with no complications. The other 4 cases were switched to laparoscopic cholecystectomy because of tiny stones blocking the cystic duct or submucosal stones. The success rate was 93.8%. Follow-up included both clinical assessment and ultrasound examination every 6 months after the operation. The patients with preoperative symptoms were symptom-free, and gallbladder function was well preserved. The overall stone recurrence rate was 4.92% at a mean follow-up of 26 months (range 6-40). CONCLUSIONS Using the laparoscope combined with the soft choledochoscope for gallbladder-preserving cholecystolithotomy can remove stones, preserve gallbladder function, and effectively avoid the various complications of cholecystectomy. In our follow-up, gallbladder function was not affected and the stone recurrence rate was quite low.
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Affiliation(s)
- Yu-Yan Tan
- Department of General Surgery, Institute for Minimally Invasive Surgery, Zhongda Hospital, Medical School, Southeast University, Nanjing, PR China
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Ma WJ, Zhou Y, Shrestha A, Mao H, Li FY, Cheng NS, Zhang W, Xu RH, Zhang YQ, Jiang T, Feng H, Li W, Han Q. Applying chemical bile duct embolization to achieve chemical hepatectomy in hepatolithiasis: a further experimental study. J Surg Res 2013; 187:113-21. [PMID: 24290428 DOI: 10.1016/j.jss.2013.10.053] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 10/23/2013] [Accepted: 10/25/2013] [Indexed: 02/05/2023]
Abstract
BACKGROUND Hepatolithiasis is the presence of calculi within the bile ducts of the liver. It represents a significant problem for hepatobiliary surgery because of its high recurrence rate and the associated risk for partial hepatectomy. This study was designed to explore the long-term efficacy of chemical biliary duct embolization (CBDE) to treat recurrent hepatolithiasis. MATERIALS AND METHODS A rabbit model of hepatolithiasis was established, and CBDE was achieved using oxybenzene and N-butyl-cyanoacrylate. The short-term (6 wk) and long-term (12 wk) efficacy of CBDE treatment was compared by observing the degree of atrophy, fibrosis, proliferation of collagen fibers, and apoptosis of hepatocytes and hepatic stellate cells in the embolized hepatic lobe. Biochemical measurement of β-glucuronidase was also evaluated to determine the effect of CBDE on stone formation. RESULTS Six weeks after CBDE, there was liver cell destruction, collagen accumulation, and bile duct proliferation only in the peripheral part of the target lobe. Twelve weeks after CBDE, "self-cut" chemical hepatectomy was achieved, as manifested by the destruction of almost all the hepatocytes in the target lobe, bile duct proliferation, and collagen fiber accumulation. The β-glucuronidase activity was markedly lower in the embolized lobe than in the nonembolized lobe. In contrast, bax, caspase-3, caspase-9, and α-smooth muscle actin expression was substantially higher in the embolized lobe than in the sham-operation group at 6 wk, but was lower at 12 wk. CONCLUSIONS CBDE is a potentially effective therapeutic approach for treating and preventing the recurrence of hepatolithiasis.
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Affiliation(s)
- Wen-jie Ma
- Department of Hepatobiliary Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Yong Zhou
- Department of Hepatobiliary Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Anuj Shrestha
- Department of Hepatobiliary Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Hui Mao
- Department of Medicine, West China Hospital of Sichuan University, Chengdu, China.
| | - Fu-yu Li
- Department of Hepatobiliary Surgery, West China Hospital of Sichuan University, Chengdu, China.
| | - Nan-sheng Cheng
- Department of Hepatobiliary Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Wei Zhang
- Department of Medicine, The George Washington University, Washington, District of Columbia
| | - Rui-hua Xu
- Department of Hepatobiliary Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Yong-qiong Zhang
- Department of Hepatobiliary Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Ting Jiang
- Department of Hepatobiliary Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Huan Feng
- Department of Hepatobiliary Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Wen Li
- Department of Hepatobiliary Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Qiang Han
- Department of Hepatobiliary Surgery, West China Hospital of Sichuan University, Chengdu, China
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Jiang ZY, Sheng X, Xu CY, Li WW, Chang XX, Sun LY, Yang XB, Yu LF. Gallbladder gallstone disease is associated with newly diagnosed coronary artery atherosclerotic disease: a cross-sectional study. PLoS One 2013; 8:e75400. [PMID: 24058685 PMCID: PMC3776774 DOI: 10.1371/journal.pone.0075400] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2013] [Indexed: 12/11/2022] Open
Abstract
Background and Aims The association between gallstone disease and coronary artery atherosclerotic disease (CAD) remains unclear. To clarify their relationship, patients with CAD newly diagnosed by coronary angiography were investigated in this cross-sectional study. Methods The study cohort consisted of 1,270 patients undergoing coronary angiography for the first time between January 2007 and September 2011. Patients with ≥50% diameter stenosis in any major coronary artery on coronary angiography were defined as being CAD positive (n = 766) and those with no stenosis as CAD negative (n = 504). Multivariate logistic regression was used to investigate the relationship between gallstone disease and CAD. The odds ratios (OR) of factors associated with CAD were calculated. In addition, CAD-positive and CAD-negative patients were matched one-to-one by age, gender and metabolic syndrome (MetS), and the association between gallbladder disease and CAD was determined. Results The prevalence of gallstone disease was significantly higher in CAD-positive than in CAD negative patients (149/766 [19.5%] vs 57/504 [11.3%], P<0.01). Gallstone disease was significantly associated with CAD (adjusted OR = 1.59, 95% confidence interval [CI] 1.10–2.31). Following matched pairing of 320 patients per group, gallstone disease remained significantly associated with CAD (adjusted OR = 1.69, 95% CI: 1.08–2.65). Conclusion Gallstone disease is strongly associated with CAD diagnosed by coronary angiography.
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Affiliation(s)
- Zhao-Yan Jiang
- Department of Surgery, Shanghai Institute of Digestive Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xia Sheng
- Division of Biostatistics, Center of Service Science, Shanghai Advanced Research Institute, Chinese Academy of Science, Shanghai, China
| | - Chen-Ying Xu
- Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei-Wei Li
- Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xian-Xing Chang
- Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lu-Ying Sun
- Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiao-Bo Yang
- Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li-Fen Yu
- Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- * E-mail:
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