Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Sep 27, 2024; 16(9): 2823-2828
Published online Sep 27, 2024. doi: 10.4240/wjgs.v16.i9.2823
Establishment and evaluation of prediction model of recurrence after laparoscopic choledocholithotomy
Ying-Jie Wu
Ying-Jie Wu, Department of Hepatobiliary Pancreatic Surgery, The First Affiliated Hospital of Ningbo University, Ningbo 315000, Zhejiang Province, China
Author contributions: Wu YJ conceived, designed acquired, analyzed, interpreted data, revised and drafted the article, and approved the final version of the article.
Institutional review board statement: The study was approved by the First Hospital of Ningbo University.
Informed consent statement: The study was exempted from informed consent by the First Affiliated Hospital of Ningbo University.
Conflict-of-interest statement: Authors declare no conflict of interests in publishing this manuscript.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ying-Jie Wu, Doctor, Department of Hepatobiliary Pancreatic Surgery, The First Affiliated Hospital of Ningbo University, No. 58 Liu Ting Road, Ningbo 315000, Zhejiang Province, China. wuyingjie0327@163.com
Received: February 19, 2024
Revised: July 16, 2024
Accepted: August 5, 2024
Published online: September 27, 2024
Processing time: 211 Days and 12.6 Hours
Abstract
BACKGROUND

Choledocholithiasis is a common clinical bile duct disease, laparoscopic choledocholithotomy is the main clinical treatment method for choledocholithiasis. However, the recurrence of postoperative stones is a big challenge for patients and doctors.

AIM

To explore the related risk factors of gallstone recurrence after laparoscopic choledocholithotomy, establish and evaluate a clinical prediction model.

METHODS

A total of 254 patients who underwent laparoscopic choledocholithotomy in the First Affiliated Hospital of Ningbo University from December 2017 to December 2020 were selected as the research subjects. Clinical data of the patients were collected, and the recurrence of gallstones was recorded based on the postoperative follow-up. The results were analyzed and a clinical prediction model was established.

RESULTS

Postoperative stone recurrence rate was 10.23% (26 patients). Multivariate Logistic regression analysis showed that cholangitis, the diameter of the common bile duct, the diameter of the stone, number of stones, lithotripsy, preoperative total bilirubin, and T tube were risk factors associated with postoperative recurrence (P < 0.05). The clinical prediction model was ln (p/1-p) = -6.853 + 1.347 × cholangitis + 1.535 × choledochal diameter + 2.176 × stone diameter + 1.784 × stone number + 2.242 × lithotripsy + 0.021 × preoperative total bilirubin + 2.185 × T tube.

CONCLUSION

Cholangitis, the diameter of the common bile duct, the diameter of the stone, number of stones, lithotripsy, preoperative total bilirubin, and T tube are the associated risk factors for postoperative recurrence of gallstone. The prediction model in this study has a good prediction effect, which has a certain reference value for recurrence of gallstone after laparoscopic choledocholithotomy.

Keywords: Choledocholithiasis; Laparoscopic choledocholithotomy; Recurrence; Risk factors; Clinical prediction model

Core Tip: To explore the related risk factors of gallstone recurrence after laparoscopic choledocholithotomy, establish and evaluate a clinical prediction model. A total of 254 patients who underwent laparoscopic choledocholithotomy in the First Affiliated Hospital of Ningbo University from December 2017 to December 2020 were selected as the research subjects. Clinical data of the patients were collected, and the recurrence of gallstones was recorded based on the postoperative follow-up.