Risk factors of systematic biliary complications in patients with gallbladder stones.

BACKGROUND

Gallbladder stone with symptom is an indication of cholecystectomy according to the current guideline. However, about 80% of gallstone patients are asymptomatic. The identification of gallbladder stone patients likely to develop symptomatic complications would be of benefit in clinical practice.

AIMS: The aim of this study was to investigate the risk factors for asymptomatic gallstone diseases developing into a gallstone-related biliary event.

METHODS

This retrospective study evaluated 1284 patients with gallstones and received laparoscopic cholecystectomy (LC) in Peking Union Medical College Hospital. The age-gender-matched patients were divided into the acute cholecystitis group (group A), biliary colic group (group B), and asymptomatic gallstone group (group C). Baseline clinical characteristics and serum biochemical indexes were recorded and analyzed among the groups. Univariate logistic regression and multivariate Cox proportional hazard regression analysis were performed to determine the risk factors.

RESULTS

The incidence of diabetes, hypertension, and sludge was higher in group A than in group B and in group C. The concentrations of plasma HDL in group A were lower than those in group B and group C (P < 0.05, 1.12 ± 0.19, vs. 1.21 ± 0.22, vs. 1.21 ± 0.21). Logistic regression analysis showed that diabetes (OR = 1.39, 95% CI 1.07-1.56, P = 0.028), sludge (OR = 1.09, 95% CI 1.01-1.18, P = 0.022), HDL (OR = 0.85, 95% CI 0.70-1.02, P = 0.045), and FBG (1.91, 95% CI 1.26-2.90, P = 0.034) were significantly associated with biliary events.

CONCLUSIONS

Diabetes, sludge, and lower blood HDL level are risk factors for symptomatic gallstone diseases.