A Retrospective Study On The Factors Of Stone Recurrence After Gallstone Preservation And Traditional Chinese Medicine To Prevent Stone Recurrence

Purpose:Through Meta analysis,the literature database in both Chinese and English was searched,and the relevant literature was summarized and analyzed to explore the risk factors of gallstone recurrence after gallblade-preserving lithotomy,and to study the efficacy of xiaochaihu decoction for preventing gallstone recurrence after gallblade-preserving lithotomy.Material and method : The retrieval methods of electronic network and manual retrieval were used to cross each other.The domestic literature databases were selected: cnki database,chongqing weipu database,wanfang database,China biomedical literature database(CBM).Foreign literature database selection: Pubmed database,Cochrane library database and Embase database.The language is limited to Chinese and English,and the time is limited to the construction of the library.Note Express software was used to screen literatures according to the pre-established inclusion and exclusion criteria,and then quality evaluation and data extraction were conducted.Finally,Review Manager5.3 software was used for Meta analysis and Stata14.0 software for publication bias detection.And,according to the results of the meta-analysis combined with clinical patients,retrospective collection of liaoning university hospital of traditional Chinese medicine since September 2017-December 2019 cases of complete follow-up records during the period of chronic cholecystitis with gall bladder calculi parallel laparoscopic joint choledochoscope confirmed 73 cases of gallbladder stone extraction for patients in the hospital,after surgery on a regular basis to our appointment,on the basis of the drug cases can be divided into Chinese medicine group 52 cases(taking small bupleurum decoction and cutting)and control group 21 cases(not taking small bupleurum decoction and cutting),postoperative follow-up time was 6 months to 1.5 years.Select cases according to inclusion and exclusion criteria,input qualified case information into Excel to form a database.The comparison of the recurrence of cholecystolithiasis was made based on the results of conventional color doppler ultrasound of the abdomen,liver,gallbladder and spleen in the two groups of patients,so as to evaluate the efficacy and application value of xiaochaihu decoction for preventing the recurrence of gallstones aftercholecystolithotomy.Result:1.Meta-data analysis was conducted on the included literatures,and the results showed that patients with high number of stones,positive family history of cholelithiasis,greasy diet,thick gallbladder wall(?3mm),poor gallbladder systolic function,and no ursodeoxycholic acid were more likely to have recurrence of gallstones after gallbladder-preserving lithotomy,regardless of gender,age or diabetes of the patients.2.A total of 73 cases were included in this retrospective study,including 52 cases in the treatment group and 21 cases in the observation group.Reexamination 6 months after the operation showed no recurrence of calculi in both groups.One year after the operation,there was no recurrence of calculi in the treatment group and 2 cases in the observation group.Review 1.5 years after surgery,1 case of stone recurrence in the treatment group and 2 cases of stone recurrence in the observation group.During the follow-up period,1 case of stone recurrence in the treatment group(1/52)and 4 cases of stone recurrence in the observation group(4/21)had a total recurrence rate of 6.8%(5/73),with statistically significant differences(p<0.05).The recurrence rate of gallstones was 12 times higher in the observation group than in the treatment group(OR=12).Conclusion:1.The number of gallstones,family history of cholelithiasis,greasy diet and thickness of gallbladder wall are the related risk factors for recurrence of gallstones after cholecystolithotomy.2.Xiaochaihu decoction has a good effect on preventing the recurrence of gallstones after cholelithiasis removal caused by a large number of stones.There are no obvious adverse reactions and toxic side effects in the whole clinical trial process,and the treatment is reliable and safe.It provides another more effective treatment scheme for clinical patients,which is worthy of clinical promotion.