医学
Roux-en-Y吻合术
胆结石
胃切除术
入射(几何)
胃肠病学
胃分流术
倾向得分匹配
比例危险模型
癌症
内科学
回顾性队列研究
吻合
外科
肥胖
减肥
物理
光学
作者
Baoping Zhang,Peng Nie,Yanyan Lin,Zhonghua Ma,Gaolei Ma,Yongjin Wang,Yuhu Ma,Jinyu Zhao,Jinduo Zhang,Ping Yue,Ningzu Jiang,Xianzhuo Zhang,Ting Liang,Linlin Lu,Jinqiu Yuan,Wenbo Meng
标识
DOI:10.1097/js9.0000000000001136
摘要
Background: Roux-en-Y reconstruction is a common anastomosis technique during gastrectomy in gastric cancer. There is a lack of studies on gallstones after Roux-en-Y reconstruction gastrectomy. This study investigated the incidence and potential risk factors associated with gallstones after Roux-en-Y reconstructive gastrectomy in gastric cancer. Methods: The study analyzed data from gastric cancer who underwent radical gastrectomy and Roux-en-Y reconstruction at two hospitals between January 2014 and December 2020. The patients fall into distal and total gastrectomy groups based on the extent of gastrectomy. The cumulative event probability curve was plotted using the Kaplan-Meier, and differences in gallstone between groups were evaluated using the Log-Rank. Propensity score matching (PSM) was applied to construct a balanced total versus distal gastrectomies cohort. A Cox regression was employed to analyze the risk factors for gallstones after Roux-en-Y reconstructive gastrectomy in gastric cancer. Further subgroup analysis was performed. Results: 531 patients were included in this study, 201 in the distal gastrectomy group and 330 in the total gastrectomy. During the follow-up, there were 170 cases (32.02%) of developed gallstones, 145 cases of gallstones constituting 85.29% of all gallstones within two years after gastrectomy. Then, to reduce the impact of bias, a 1: 1 propensity score matching analysis was performed on the two groups of patients. A total of 344 patients were evaluated, with each subgroup comprising 172 patients. In the matched population, the Cox regression analysis revealed that females, BMI ≥ 23 kg/m 2 , total gastrectomy, No.12 lymph node dissection, and adjuvant chemotherapy were risk factors for gallstones after Roux-en-Y reconstructive gastrectomy. Subgroup analysis revealed a significantly higher incidence of gallstones after open total gastrectomy than after open distal gastrectomy. Conclusion: Significantly higher incidence of gallstones within two years after Roux-en-Y reconstructive gastrectomy for gastric cancer. Patients with these risk factors should be followed closely after gastrectomy to avoid symptomatic gallstones.
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