Ultrasonographic signs as factors for recurrence of gallstones and polypoid lesions of the gallbladder after gallbladder-preserving surgery / 临床肝胆病杂志

ABSTRACT

ObjectiveTo investigate ultrasonographic signs as the factors for the recurrence of gallstones and polypoid lesion of the gallbla-dder in patients undergoing gallbladder-preserving surgery. MethodsRelated 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. ResultsThe 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). ConclusionUltrasonography 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.