Objective To investigate ultrasonographic signs as the factors for the recurrence of gallstones and polypoid lesion of the gallbla-dder in patients undergoing gallbladder- preserving surgery. Methods Related signs including gallbladder size,sound transmission of the gallbladder,gallbladder wall thickness,cholestasis,gallbladder contraction function,and common bile duct diameter measured by preoperative and postoperative ultrasonography,as well as the recurrence of gallstones and polypoid lesions of the gallbladder after surgery,were collected from 700 patients who underwent gallbladder- preserving surgery in Huangshi Central Hospital from January 2011 to February 2015.The Fisher's exact test and Cox proportional hazards regression model were applied for univariate and multivariate analysis of related factors for recurrence after gallbladder- preserving surgery. Results The shortest and longest follow- up time was 6 months and 48 months,respectively,and the mean follow- up time was 18 ± 12 months. Among the 700 patients,1 experienced recurrence of gallstones at 1 month after surgery,2 experienced recurrence of gallstones at 6 months after surgery,1 experienced recurrence of gallstones at 12 months after surgery,and 1 experienced recurrence of polypoid lesions of the gallbladder at 24 months after surgery. The mean time to recurrence of gallstones and polypoid lesions was 9. 8 months after surgery,and the recurrence rate was 0. 71%( 5 /700). The univariate analysis showed that gallbladder wall thickness ≥4 mm,gallbladder contraction function < 30%,and cholestasis were significantly associated with the recurrence of gallstones and polypoid lesions( all P < 0. 05). The multivariate analysis showed that gallbladder wall thickness ≥4 mm,cholestasis,and gallbladder contraction function < 30% were independent factors for recurrence after gallbladder- preserving surgery( P = 0. 000 3,0. 040 0,and 0. 040 0). Conclusion Ultrasonography shows that gallbladder wall thickness ≥4 mm,gallbladder contraction function < 30%,and cholestasis are closely associated with the recurrence of gallstones and polypoid lesions of the gallbladder.
[1]SONG ZW.Significance of cholestasis in gallbladder and gallbladder wall thickening in ultrasonic diagnosis[J].Int J Surg,1992,5:311.(in Chinese)宋志武.胆囊内胆汁淤积和胆囊壁增厚在超声诊断中的意义[J].国际外科学杂志,1992,5:311.
|
[2]ZHANG H,PAN YZ,ZHANG H,et al.Contrastive study for treatment of cholecystolithiasis by minimally invasive cholecystolithotomy with gallbladder reservation combined tauroursodeoxycholic acid and laparoscopic cholecystectomy[J/CD].Chin J Clinicians:Electronic Edition,2014,8(5):873-878.(in Chinese)张宏,潘耀振,张浩,等.微创保胆取石联合牛黄熊去氧胆酸与腹腔镜胆囊切除术治疗胆囊结石的对比研究[J/CD].中华临床医师杂志:电子版,2014,8(5):873-878.
|
[3]GU H,CAO J,ZHAO JM,et al.Mata analysis on domestic minicholecystolithotomy with gallbladder preserved[J].China J Modern Med,2008,18(22):3355-3357.(in Chinese)谷昊,曹峻,赵晋明,等.国内保胆取石荟摹分析[J].中国现代医学杂志,2008,18(22):3355-3357.
|
[4]LU QP.Controversy and consensus of reserve or removal gallbladder for cholecystitis and gallstone[J].Chin J Pract Surg,2015,35(1):49-53.(in Chinese)卢绮萍.慢性胆囊炎胆囊结石行保留及切除胆囊的争议与共识[J].中国实用外科杂志,2015,35(1):49-53.
|
[5]RONG WS.Clinical evaluation of mini-cholecystolithotomy for gallstones[J].China J Endosc,2002,8(12):21-23.(in Chinese)荣万水.微创胆囊切开取石术的临床评价[J].中国内镜杂志,2002,8(12):21-23.
|
[6]ZHANG PQ,LI QM,LIU LY,et al.Preventative effect of lidanfangshi powder on relapse of lithiasis after microinvasive gallbladder protected lithotomy[J].Chin Gen Pract,2010,13(3):991.(in Chinese)张培琴,李卿明,刘伦扬,等.利胆防石散对微创保胆取石术后胆囊结石复发的预防作用[J].中国全科医学,2010,13(3):991.
|
[7]HOU YK,LI ZH,WANG WZ,et al.The clinical analysis of combined laparoscopic and choledochoscopiclithotomy with gallbladder preservation during three years of follow-up after surgery:report of239 cases[J].China J Endosc,2014,20(12):1268-1271.(in Chinese)候元凯,李振华,王伟智,等.239例腹腔镜联合胆道镜保胆取石术后3年临床随访分析[J].中国内镜杂志,2014,20(12):1268-1271.
|
[8]WANG Q,YANG P,WANG CG,et al.Stage and grade-based surgical strategy for gallstone disease:the experiences of 441 cases of gallbladder preserving cholecystolithotomy[J].China J Endosc,2014,20(3):225-229.(in Chinese)王青,杨平,王成果,等.胆囊结石分级分期治疗策略-附441例保胆手术经验总结与体会[J].中国内镜杂志,2014,20(3):225-229.
|
[9]ZHANG DJ,LEI P,ZHAO GZ.Operation method and surgical indications for minimally invasive endoscopic gallbladder-preserving cholecystolithotomy(polypectomy)[J].J Ningxia Med Univ,2015,37(2):230-232.(in Chinese)张多钧,雷鹏,赵国忠.内镜微创保胆取石(息肉)术式及手术指征[J].宁夏医科大学学报,2015,37(2):230-232.
|
[10]CUI HJ,ZHAO WP,WANG XY,et al.Value of ultrasonic gallbladder function classification in minimally invasive gallbladderpreserving cholecystolithotomy[J].Guide China Med,2013,11(34):466-467.(in Chinese)崔惠娟,赵文鹏,王新燕,等.超声下胆囊功能分级在微创保胆取石术中的应用价值分析[J].中国医药指南,2013,11(34):466-467.
|
[11]ZHANG HP.Experience in treatment of 326 patients with gallstones[J].J Clin Hepatol,2015,31(5):741-744.(in Chinese)张和平.326例胆囊结石患者规范化治疗的体会[J].临床肝胆病杂志,2015,31(5):741-744.
|
[12]ZHANG PH,XIA X,LIAN SS,et al.Application of gallbladder function evaluation by ultrasound in minimally invasive gallbladder-preserving cholecystolithotomy[J].China Foreign Med Treatment,2010,29(23):174-175.(in Chinese)张片红,夏香,廉世松,等.B超评价胆囊功能在微创保胆取石术的应用[J].中外医疗,2010,29(23):174-175.
|
[13]HUANG HY,MA RH,QIAO T,et al.Effect of gallbladder-preserving cholelithotomy using rigid endoscope on gallbladder wall thickness in gallstone patients[J].China J Modern Med,2015,23(8):95-98.(in Chinese)黄海仪,马瑞红,乔铁,等.硬镜保胆取石对胆囊结石患者胆囊壁厚度的作用分析[J].中国现代医学杂志,2015,23(8):95-98.
|