Symptomatic gallstone disease: Recurrence patterns and risk factors for relapse after first admission, the RELAPSTONE study

BackgroundDelayed cholecystectomy in patients with symptomatic gallstone disease is associated with recurrence. Limited data on the recurrence patterns and the factors that determine them are available.ObjectiveWe aimed to determine the pattern of relapse in each symptomatic gallstone disease (acute...

Descripción completa

Detalles Bibliográficos
Autores: Velamazán, R, López-Guillén, P, Martínez-Domínguez, SJ, Baroja, DA, Oyón, D, Arnau, A, Ruiz-Belmonte, LM, Tejedor-Tejada, J, Zapater, R, Martín-Vicente, N, Fernández-Esparcia, PJ, Gomara, ABJ, Lozano, VS, García, JJM, Martín-Falquina, IC, Pascual, LA, Monclus, NT, Velasco, NZ, Rojo, E, Lapeña-Muñoz, B, Flores, V, Gómez, AD, Cañamares-Orbís, P, Abizanda, IV, Carrasco, NM, Grau, LP, García-Rayado, G, Bocos, JM, de Paredes, AGG, Lorenzo, MV, Arostegi, AI, Lozada-Hernández, EE, Velasco, JAVR, de-Madaria, E
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
Repositorio:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
OAI Identifier:oai:isabial.fundanetsuite.com:p10178
Acceso en línea:https://isabial.portalinvestigacion.com/publicaciones10178
https://onlinelibrary.wiley.com/doi/10.1002/ueg2.12544
Access Level:acceso abierto
Palabra clave:biliary colic
biliary pain
cholangitis
cholecystectomy
cholecystitis
cholelithiasis
gallstones
pancreatitis
recurrences
relapse
Descripción
Sumario:BackgroundDelayed cholecystectomy in patients with symptomatic gallstone disease is associated with recurrence. Limited data on the recurrence patterns and the factors that determine them are available.ObjectiveWe aimed to determine the pattern of relapse in each symptomatic gallstone disease (acute pancreatitis, cholecystitis, cholangitis, symptomatic choledocholithiasis, and biliary colic) and determine the associated factors.MethodsRELAPSTONE was an international multicenter retrospective cohort study. Patients (n = 3016) from 18 tertiary centers who suffered a first episode of symptomatic gallstone disease from 2018 to 2020 and had not undergone cholecystectomy during admission were included. The main outcome was relapse-free survival. Kaplan-Meier curves were used in the bivariate analysis. Multivariable Cox regression models were used to identify prognostic factors associated with relapses.ResultsMean age was 76.6 [IQR: 59.7-84.1], and 51% were male. The median follow-up was 5.3 months [IQR 2.1-12.4]. Relapse-free survival was 0.79 (95% CI: 0.77-0.80) at 3 months, 0.71 (95% CI: 0.69-0.73) at 6 months, and 0.63 (95% CI: 0.61-0.65) at 12 months. In multivariable analysis, older age (HR = 0.57; 95% CI: 0.49-0.66), sphincterotomy (HR = 0.58, 95% CI: 0.49-0.68) and higher leukocyte count (HR = 0.79; 95% CI: 0.70-0.90) were independently associated with lower risk of relapse, whereas higher levels of alanine aminotransferase (HR = 1.22; 95% CI: 1.02-1.46) and multiple cholelithiasis (HR = 1.19, 95% CI: 1.05-1.34) were associated with higher relapse rates.ConclusionThe relapse rate is high and different in each symptomatic gallstone disease. Our independent predictors could be useful for prioritizing patients on the waiting list for cholecystectomies. image

Similares en LA Referencia