Risk factors for gallbladder contractility after cholecystolithotomy in elderly high-risk surgical patients

Tao Wang,* Hao Luo,* Hong-tao Yan,* Guo-hu Zhang, Wei-hui Liu, Li-jun Tang General Surgery Center, Chengdu Military General Hospital, Chengdu, Sichuan, People’s Republic of China *These authors contributed equally to this work Objective: Cholecystolithiasis is a common disease...

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Autores principales:	Wang T, Luo H, Yan H, Zhang G, Liu W, Tang L
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	cholecystolithotomy lithotrity thickness of cholecyst wall GBEF cholecystic contractility Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/826088e972094bd792c9eb74a5b55605
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spelling	oai:doaj.org-article:826088e972094bd792c9eb74a5b556052021-12-02T07:10:34ZRisk factors for gallbladder contractility after cholecystolithotomy in elderly high-risk surgical patients1178-1998https://doaj.org/article/826088e972094bd792c9eb74a5b556052017-01-01T00:00:00Zhttps://www.dovepress.com/risk-factors-for-gallbladder-contractility-after-cholecystolithotomy-i-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Tao Wang,* Hao Luo,* Hong-tao Yan,* Guo-hu Zhang, Wei-hui Liu, Li-jun Tang General Surgery Center, Chengdu Military General Hospital, Chengdu, Sichuan, People’s Republic of China *These authors contributed equally to this work Objective: Cholecystolithiasis is a common disease in the elderly patient. The routine therapy is open or laparoscopic cholecystectomy. In the previous study, we designed a minimally invasive cholecystolithotomy based on percutaneous cholecystostomy combined with a choledochoscope (PCCLC) under local anesthesia. Methods: To investigate the effect of PCCLC on the gallbladder contractility function, PCCLC and laparoscope combined with a choledochoscope were compared in this study. Results: The preoperational age and American Society of Anesthesiologists (ASA) scores, as well as postoperational lithotrity rate and common biliary duct stone rate in the PCCLC group, were significantly higher than the choledochoscope group. However, the pre- and postoperational gallbladder ejection fraction was not significantly different. Univariable and multivariable logistic regression analyses indicated that the preoperational thickness of gallbladder wall (odds ratio [OR]: 0.540; 95% confidence interval [CI]: 0.317–0.920; P=0.023) and lithotrity (OR: 0.150; 95% CI: 0.023–0.965; P=0.046) were risk factors for postoperational gallbladder ejection fraction. The area under receiver operating characteristics curve was 0.714 (P=0.016; 95% CI: 0.553–0.854). Conclusion: PCCLC strategy should be carried out cautiously. First, restricted by the diameter of the drainage tube, the PCCLC should be used only for small gallstones in high-risk surgical patients. Second, the usage of lithotrity should be strictly limited to avoid undermining the gallbladder contractility and increasing the risk of secondary common bile duct stones. Keywords: cholecystolithotomy, lithotrity, thickness of gallbladder wall, GBEF, gallbladder motilityWang TLuo HYan HZhang GLiu WTang LDove Medical Pressarticlecholecystolithotomylithotritythickness of cholecyst wallGBEFcholecystic contractilityGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 12, Pp 129-136 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	cholecystolithotomy lithotrity thickness of cholecyst wall GBEF cholecystic contractility Geriatrics RC952-954.6
spellingShingle	cholecystolithotomy lithotrity thickness of cholecyst wall GBEF cholecystic contractility Geriatrics RC952-954.6 Wang T Luo H Yan H Zhang G Liu W Tang L Risk factors for gallbladder contractility after cholecystolithotomy in elderly high-risk surgical patients
description	Tao Wang,* Hao Luo,* Hong-tao Yan,* Guo-hu Zhang, Wei-hui Liu, Li-jun Tang General Surgery Center, Chengdu Military General Hospital, Chengdu, Sichuan, People’s Republic of China *These authors contributed equally to this work Objective: Cholecystolithiasis is a common disease in the elderly patient. The routine therapy is open or laparoscopic cholecystectomy. In the previous study, we designed a minimally invasive cholecystolithotomy based on percutaneous cholecystostomy combined with a choledochoscope (PCCLC) under local anesthesia. Methods: To investigate the effect of PCCLC on the gallbladder contractility function, PCCLC and laparoscope combined with a choledochoscope were compared in this study. Results: The preoperational age and American Society of Anesthesiologists (ASA) scores, as well as postoperational lithotrity rate and common biliary duct stone rate in the PCCLC group, were significantly higher than the choledochoscope group. However, the pre- and postoperational gallbladder ejection fraction was not significantly different. Univariable and multivariable logistic regression analyses indicated that the preoperational thickness of gallbladder wall (odds ratio [OR]: 0.540; 95% confidence interval [CI]: 0.317–0.920; P=0.023) and lithotrity (OR: 0.150; 95% CI: 0.023–0.965; P=0.046) were risk factors for postoperational gallbladder ejection fraction. The area under receiver operating characteristics curve was 0.714 (P=0.016; 95% CI: 0.553–0.854). Conclusion: PCCLC strategy should be carried out cautiously. First, restricted by the diameter of the drainage tube, the PCCLC should be used only for small gallstones in high-risk surgical patients. Second, the usage of lithotrity should be strictly limited to avoid undermining the gallbladder contractility and increasing the risk of secondary common bile duct stones. Keywords: cholecystolithotomy, lithotrity, thickness of gallbladder wall, GBEF, gallbladder motility
format	article
author	Wang T Luo H Yan H Zhang G Liu W Tang L
author_facet	Wang T Luo H Yan H Zhang G Liu W Tang L
author_sort	Wang T
title	Risk factors for gallbladder contractility after cholecystolithotomy in elderly high-risk surgical patients
title_short	Risk factors for gallbladder contractility after cholecystolithotomy in elderly high-risk surgical patients
title_full	Risk factors for gallbladder contractility after cholecystolithotomy in elderly high-risk surgical patients
title_fullStr	Risk factors for gallbladder contractility after cholecystolithotomy in elderly high-risk surgical patients
title_full_unstemmed	Risk factors for gallbladder contractility after cholecystolithotomy in elderly high-risk surgical patients
title_sort	risk factors for gallbladder contractility after cholecystolithotomy in elderly high-risk surgical patients
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/826088e972094bd792c9eb74a5b55605
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_version_	1718399581522231296

Risk factors for gallbladder contractility after cholecystolithotomy in elderly high-risk surgical patients

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