Risk factors for the recurrence of stones after endoscopic minimally invasive cholecystolithotomy in China: a meta-analysis
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The recurrence of stones after endoscopic minimally invasive cholecystolithotomy (EMIC) remains a hazardous problem in patients with cholelithasis. We sought to evaluate the risk factors for recurrence after cholecystolithotomy and to provide a theoretical basis for the indication for cholecystolithotomy.
We searched the Cochrane Library, PubMed, EMBASE, WanFang Data, CNKI and VIP Data to identify controlled trials related to cholelithasis that were published between 2007 and 2016. The odds ratios (ORs) were calculated with 95% confidence intervals (CIs). Stata12.0 was used to test the heterogeneity and publication bias.
Eight studies involving 1663 participants were selected. No significant differences were observed in hazardous factors including advanced age, gender and diabetes mellitus compared with the control groups. However, family history of cholelithasis, multiple calculi, gallbladder wall thickening (GBWT) over 3 mm, a preference for greasy food, dysfunction of the gallbladder and not taking oral ursodeoxycholic acid post-EMIC yielded pooled ORs (95% CI) of 3.28 (2.30, 4.66), 4.24 (2.76, 6.50), 18.4 (7.23, 46.83), 1.90 (1.20, 3.01), 26.16 (10.15, 62.34) and 2.90 (1.36, 6.15), respectively.
A family history of cholelithasis, multiple calculi, a GBWT ≥ 3 mm, a preference for greasy food, dysfunction of the gallbladder and not taking oral ursodeoxycholic acid post-EMIC are hazardous factors for stones and sludge after cholecystolithotomy.
KeywordsCholelithasis Gallbladder preserved Stones recurrence Risk factors EMIC
National Natural Science Foundation of China, No. 81702375. Natural Science Foundation of Guangdong Province, No. 2016A030313200. Science and Technology Project of Guangzhou City, No. 201607010022. Natural Science Foundation of Guangdong Province, No. 2017A030313580. Fundamental Research Funds for the Central Universities (Sun Yat-sen University), No. 17ykp.
Compliance with ethical standards
Drs. Wenchao Li, Pinzhu Huang, Zhicheng Yao, Purun Lei, Hui Luo, Zhiyong Xiong, Bo Liu and Kunpeng Hu have no conflicts of interest or financial ties to disclose.
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