| Objective: To analyze endoscopic ultrasonography-guided stomach/duodenumgallbladder anastomosis and endoscopic gallbladder-preserving cholecystolithotomy,review the clinical characteristics of the cases,analyze the characteristics of the patients before the operation,observe various clinical indicators during the operation.After that,the patients were followed up for a long time to observe the prognosis of the patients,and analyze the influencing factors of the complications and recurrence of stones.Realize a comprehensive and accurate evaluation and analysis of this procedure,providing new ideas for the treatment of gallbladder stones and other gallbladder diseases.Methods: A retrospective cohort study method was adopted.The clinical data of 44 patients who underwent endoscopic ultrasonography-guided stomach/duodenumgallbladder anastomosis and endoscopic gallbladder-preserving cholecystolithotomy in Shengjing Hospital of China Medical University from December 2015 to June 2020 were selected.The characteristics of the cases include: gender,age,BMI,whether they are combined with diabetes,hypertension,coronary heart disease,whether they are combined with bile duct stones,acute cholecystitis,whether gallbladder stones are multiple or single,whether there is a family history of biliary system diseases;intraoperative observation indicators Including: surgical puncture route(stomach or duodenum),technical success rate,clinical success rate,complications(bleeding,abdominal infection,stent displacement,pneumoperitoneum);regular follow-up of patients after operation,the follow-up content includes : Whether the clinical symptoms are alleviated,whether the bad eating habits are changed,whether the medication is used regularly and the duration of medication,whether the gallbladder stones recur.Results: The technical success rate of the procedure was 93.2%,the clinical success rate was 100%,and 3 patients were lost during the follow-up.The univariate analysis of chi-squared analysis suggested that whether the patient had coronary heart disease and whether he had a family history of biliary tract disease was the influencing factor of complications(P<0.05).Whether the medication was taken for more than three months after the operation and whether the bad eating habits were changed after the operation were the influencing factors for the recurrence of stones(P<0.05).Further analysis of the logistic regression model showed that the combined family history of biliary tract disease is an independent risk factor for complications,and the unchanging of bad eating habits after operation is an independent risk factor for the recurrence of gallbladder stones.Conclusion: Endoscopic ultrasonography-guided stomach/duodenum-gallbladder anastomosis and endoscopic gallbladder-preserving cholecystolithotomy is a new type of treatment for gallbladder stones,with high technical success rate and clinical success rate,and it has a good application prospect.To avoid the excessive difficulty of the operation leading to postoperative complications and the recurrence of gallbladder stones after the operation,the evaluation of the patient’s condition should be paid attention to before the operation,and the patients should change their bad eating habits after the operation. |
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