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Risk factors for the recurrence of stones after endoscopic minimally invasive cholecystolithotomy in China: a meta-analysis

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Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

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Funding

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.

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Author notes

  1. Wenchao Li and Pinzhu Huang are Co-first authors.

Authors and Affiliations

  1. Department of General Surgery, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China

    Wenchao Li, Zhicheng Yao, Zhiyong Xiong, Bo Liu & Kunpeng Hu

  2. Department of Gastrointestinal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China

    Pinzhu Huang & Purun Lei

  3. Department of Operating Room, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China

    Hui Luo

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  1. Wenchao Li
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Correspondence to Kunpeng Hu.

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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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Li, W., Huang, P., Lei, P. et al. Risk factors for the recurrence of stones after endoscopic minimally invasive cholecystolithotomy in China: a meta-analysis. Surg Endosc 33, 1802–1810 (2019). https://doi.org/10.1007/s00464-018-6455-y

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