Construction and verification of a new nomogram for predicting stone recurrence after endoscopic minimally invasive gallbladder-preserving cholecystolithotomy at high altitude

Xuepeng MEI; Xiaobin CHEN; Shizheng PI; Yichong CHEN; Junhua XING; Haijiu WANG; Shuai GAO; Ying ZHOU

doi:10.3969/j.issn.1001-5256.2021.03.028

Volume 37 Issue 3

Mar. 2021

Turn off MathJax

Article Contents

Article Navigation > Journal of Clinical Hepatology > 2021 > 37(3): 648-653

PDF( 2761 KB)

Construction and verification of a new nomogram for predicting stone recurrence after endoscopic minimally invasive gallbladder-preserving cholecystolithotomy at high altitude

DOI: 10.3969/j.issn.1001-5256.2021.03.028

Xuepeng MEI^{1, 2},
Xiaobin CHEN^{1, 2},
Shizheng PI^{1, 2},
Yichong CHEN^{1, 2},
Junhua XING³,
Haijiu WANG^{1, 2},
Shuai GAO^{1, 2},
Ying ZHOU^{1, 2
,
,}

1.
Department of Hepatopancreatobiliary Surgery, Qinghai University Affiliated Hospital, Xining 810000, China
2.
Qinghai Province Key Laboratory of Hydatid Disease Research, Xining 810000, China
3.
Department of General Surgery, Renji Hospital of Qinghai Province, Xining 810000, China

Received Date: 2020-08-31
Accepted Date: 2020-11-02
Published Date: 2021-03-20

Abstract

Abstract

Objective To investigate related factors for stone recurrence after endoscopic minimally invasive gallbladder-preserving cholecystolithotomy, and to establish a nomogram model for predicting the risk of stone recurrence after surgery based on independent risk factors. Methods A retrospective analysis was performed for the clinical data of 144 patients with gallstones who underwent endoscopic minimally invasive gallbladder-preserving cholecystolithotomy in Qinghai University Affiliated Hospital from January 2012 to January 2018, and according to postoperative stone recurrence, the patients were divided into non-recurrence group and recurrence group. The chi-square test was used for comparison of categorical data between two groups. LASSO and logistic regression analyses were used to analyze independent risk factors for postoperative stone recurrence, and the corresponding nomogram prediction model was plotted according to regression coefficient. The calibration curve was plotted to evaluate the reliability of the predictive nomogram; Harrell consistency index was used to quantify the discriminatory performance of the predictive nomogram; the receiver operating characteristic (ROC) curve was used to evaluate the sensitivity, specificity, and area under the ROC curve (AUC) of this predictive nomogram. Results All 144 patients underwent successful endoscopic minimally invasive gallbladder-preserving cholecystolithotomy, among whom 14 patients (9.7%) experienced stone recurrence after surgery. The multivariate analysis showed that family history (odds ratio [OR]= 3.245, 95% confidence interval [CI]: 0.752-13.567, P=0.104), regular diet (OR=3.752, 95% CI: 1.067-14.141, P=0.041), stone homogeneity (OR=5.871, 95% CI: 1.636-25.390, P=0.010), and medication compliance (OR=0.225, 95% CI: 0.057-0.799, P=0.024) were independent risk factors for recurrence. The nomogram model had an index of concordance (C-index) of 0.835 (95% CI: 0.732-0.938) in the modeling sample and 0.7925 in the verification sample, suggesting that the nomogram model in this study had good accuracy and discrimination. The predictive nomogram had an AUC of 0.835, suggesting that this nomogram had a relatively high predictive value. Conclusion Family history, regular diet, stone homogeneity, and medication compliance are independent risk factors for stone recurrence after endoscopic minimally invasive gallbladder-preserving cholecystolithotomy, and the nomogram constructed based on these independent risk factors may help to predict the risk of postoperative stone recurrence.
- Cholecystolithiasis,
- Recurrence,
- Nomograms

FullText(HTML)

References(22)

References

[1]	HE XY, SHI J. Consensus opinion on medical treatment of chronic cholecystitis and cholecystolithiasis in China (2018)[J]. J Clin Hepatol, 2019, 35(6): 1231-1236. (in Chinese) DOI: 10.3969/j.issn.1001-5256.2015.01.002 何相宜, 施健. 中国慢性胆囊炎、胆囊结石内科诊疗共识意见(2018年)[J]. 临床肝胆病杂志, 2019, 35(6): 1231-1236. DOI: 10.3969/j.issn.1001-5256.2015.01.002
[2]	KERLAN RK, LABERGE JM, RING EJ. Percutaneous cholecystolithotomy: Preliminary experience[J]. J Radiology, 1985, 157(3): 653-656. DOI: 10.1148/radiology.157.3.4059554
[3]	CHESLYN-CURTIS S, RUSSELL RCG. Percutaneous cholecystolithotomy[J]. BMJ Clin Res, 1990, 301(6747): 339-340.
[4]	LIEVENS M, SCHUTZ SM. Percutaneous cholecystolithotomy: Is gall stone recurrence inevitable?[J]. Gastrointest Endosc, 1995, 41(3): 271-272. http://europepmc.org/articles/PMC1374759
[5]	TAN YY, ZHAO G, WANG D, et al. A new strategy of minimally invasive surgery for cholecystolithiasis: Calculi removal and gallbladder preservation[J]. Dig Surg, 2013, 30(4-6): 466-471. DOI: 10.1159/000357823
[6]	GAO DK, WEI SH, LI W, et al. Totally laparoscopic gallbladder-preserving surgery: A minimally invasive and favorable approach for cholelithiasis[J]. Exp Ther Med, 2015, 9(2): 395-398. DOI: 10.3892/etm.2014.2107
[7]	SAUERBREI W, ROYSTON P, BINDER H. Selection of important variables and determination of functional form for continuous predictors in multivariable model building[J]. Stat Med, 2007, 26(30): 5512-5528. DOI: 10.1002/sim.3148
[8]	FRIEDMAN J, HASTIE T, TIBSHIRANI R. Regularization paths for generalized linear models via coordinate descent[J]. J Stat Softw, 2010, 33(1): 1-22. http://neuro-oncology.oxfordjournals.org/external-ref?access_num=20808728&link_type=MED
[9]	KIDD AC, MCGETTRICK M, TSIM S, et al. Survival prediction in mesothelioma using a scalable Lasso regression model: Instructions for use and initial performance using clinical predictors[J]. BMJ Open Respir Res, 2018, 5(1): e000240. DOI: 10.1136/bmjresp-2017-000240
[10]	BALACHANDRAN VP, GONEN M, SMITH JJ, et al. Nomograms in oncology: More than meets the eye[J]. Lancet Oncol, 2015, 16(4): e173-e180. DOI: 10.1016/S1470-2045(14)71116-7
[11]	IASONOS A, SCHRAG D, RAJ GV, et al. How to build and interpret a nomogram for cancer prognosis[J]. J Clin Oncol, 2008, 26(8): 1364-1370. DOI: 10.1200/JCO.2007.12.9791
[12]	KRAMER AA, ZIMMERMAN JE. Assessing the calibration of mortality benchmarks in critical care: The Hosmer-Lemeshow test revisited[J]. Crit Care Med, 2007, 35(9): 2052-2056. DOI: 10.1097/01.CCM.0000275267.64078.B0
[13]	PENCINA MJ, D'AGOSTINO RB. Overall C as a measure of discrimination in survival analysis: Model specific population value and confidence interval estimation[J]. Stat Med, 2004, 23(13): 2109-2123. DOI: 10.1002/sim.1802
[14]	ANDREW JV, ANGEL MC, ELENA BE, et al. Extensions to decision curve analysis, a novel method for evaluating diagnostic tests, prediction models and molecular markers[J]. BMC Medical Informatics and Decision Making, 2008, 8(15): 1039-1052. http://www.bmj.com/lookup/external-ref?access_num=10.1186/1472-6947-8-53&link_type=DOI
[15]	Development and validation of a radiomics nomogram for preoperative prediction of lymph node metastasis in colorectal cancer[J]. Science Foundation in China, 2016, 24(4): 35.
[16]	HAN XM, SHU XC, WANG YP. Research progress on the correlation between cholecystolithiasis, cholecystectomy and gastric cancer[J]. Med Rev, 2020, 26(13): 2559-2563, 2569. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-YXZS202013013.htm 韩雪梅, 舒小闯, 王玉平, 等. 胆囊结石及胆囊切除与胃癌相关性研究进展[J]. 医学综述, 2020, 26(13): 2559-2563, 2569. https://www.cnki.com.cn/Article/CJFDTOTAL-YXZS202013013.htm
[17]	WEI L, CHAMPMAN S, LI X, et al. Beliefs about medicines and non-adherence in patients with stroke, diabetes mellitus and rheumatoid arthritis: A cross-sectional study in China[J]. BMJ Open, 2017, 7(10): e017293. DOI: 10.1136/bmjopen-2017-017293
[18]	LI A, LIU JW, ZHANG D. Research progress on recurrence of cholecystolithiasis after endoscopic minimally invasive choledocholithiasis[J]. J Hepatopancreatobiliary Surg, 2019, 31(9): 573-577. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-GDYW201909017.htm 李骜, 刘江伟, 张东. 内镜微创保胆取石术后胆囊结石复发的研究进展[J]. 肝胆胰外科杂志, 2019, 31(9): 573-577. https://www.cnki.com.cn/Article/CJFDTOTAL-GDYW201909017.htm
[19]	CONDAT B, ZANDITENAS D, BARBU V, et al. Prevalence of low phospholipid-associated cholelithiasis in young female patients[J]. Dig Liver Dis, 2013, 45(11): 915-919. DOI: 10.1016/j.dld.2013.04.002
[20]	GE HL, WAN H. Analysis of risk factors related to recurrence of gallstones after minimally invasive endoscopic choledocholithotomy[J]. J Binzhou Med Univ, 2016, 39(2): 149-150. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-BZYB201602024.htm 葛海龙, 万航. 微创内镜保胆取石术术后胆囊结石复发的相关危险因素分析[J]. 滨州医学院学报, 2016, 39(2): 149-150. https://www.cnki.com.cn/Article/CJFDTOTAL-BZYB201602024.htm
[21]	van de MEEBERG PC, PORTINCASA P, van de HEIJNING BJM, et al. Gallbladder (GB) emptying in vivo and contractility in vitro of gallstone patients on ursodeoxycholic acid(UDCA)[J]. Neth J Med, 1996, 48(1): A39. http://www.sciencedirect.com/science/article/pii/0300297796896458
[22]	LIU T, LI N, LI D, et al. Clinical study on Xiaoshi Lidan capsule combined with ursodeoxycholic acid in the treatment of cholecystolithiasis[J]. China Pharm, 2019, 28(8): 30-32. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-YYGZ201908013.htm 刘彤, 李楠, 李栋, 等. 消石利胆胶囊联合熊去氧胆酸治疗胆囊结石临床研究[J]. 中国药业, 2019, 28(8): 30-32. https://www.cnki.com.cn/Article/CJFDTOTAL-YYGZ201908013.htm

Relative Articles

Supplements(0)

Cited By

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Figures(3) / Tables(2)

Get Citation

PDF

XML

Article Metrics

Article views (502) PDF downloads(34)

Construction and verification of a new nomogram for predicting stone recurrence after endoscopic minimally invasive gallbladder-preserving cholecystolithotomy at high altitude

DOI: 10.3969/j.issn.1001-5256.2021.03.028

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Construction and verification of a new nomogram for predicting stone recurrence after endoscopic minimally invasive gallbladder-preserving cholecystolithotomy at high altitude

DOI: 10.3969/j.issn.1001-5256.2021.03.028

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

About Journal

Submission Guideline

Journal Online

Hepatobiliary College

Guidelines

Export File

Citation

Format

Content