胃癌术后胆囊结石形成相关因素的Meta分析  

Related factors of gallstone formation after gastric cancer surgery:a meta-analysis

作　　者：王高超 杨帆[2] 何招才[2] 董鑫 矫健 武步强[2] Wang Gaochao;Yang Fan;He Zhaocai(Changzhi Medical College,Changzhi 046000)

机构地区：[1]长治医学院,山西长治046000 [2]长治医学院附属和平医院肝胆外科,山西长治046000

出　　处：《中国现代医药杂志》2022年第4期20-26,共7页Modern Medicine Journal of China

基　　金：山西省卫生健康委科研课题(编号:2019143)。

摘　　要：目的探讨胃癌术后胆囊结石形成的危险因素。方法通过检索PubMed、Cochrane Library、Embase、中国知网、万方数据库、维普数据库,收集1990年1月~2021年7月发表的有关胃癌术后发生胆囊结石的研究文献,使用RevMan 5.4软件进行Meta分析。结果共收集符合纳入标准的文献30篇,累计77102例患者。Meta分析结果显示:远端胃切除术后胆囊结石的发生率低于全胃切除术后[OR=0.64,95%CI(0.53,0.77),P<0.01];生理性重建术后胆囊结石的发生率低于非生理性重建[OR=0.59,95%CI(0.52,0.67),P<0.01]。Objective To investigate the risk factors of gallstone formation after gastric cancer surgery.Methods By searching PubMed, Cochrane Library, Embase, CNKI, Wanfang and VIP Database, collected literature published from Jan 1990 to Jul 2021 on gallbladder stones after gastric cancer and used RevMan 5.4 software for meta-analysis. Results A total of 30 documents that met the inclusion criteria were collected, and a total of 77102 patients were collected. The results of meta-analysis showed that the incidence of gallbladder stones after distal gastrectomy was lower than that after total gastrectomy [OR=0.64, 95%CI(0.53, 0.77), P<0.01];physiological reconstruction was lower than that of non-physiological reconstruction [OR=0.59, 95%CI(0.52, 0.67), P<0.01];<D2lymph node dissection was lower than that of ≥D2 lymph node dissection [OR=0.59, 95%CI(0.36, 0.97), P=0.04];vagus nerve resection was higher than that of vagus nerve preservation [OR=3.83, 95%CI(2.35, 6.24), P<0.01];there was no significant difference in the incidence of gallbladder stones after pylorus preservation and no pylorus preservation [OR=0.72, 95%CI(0.49, 1.06), P=0.09]. Conclusion Physiological reconstruction of the digestive tract and preservation of the abdominal vagus nerve decrease the incidence of postoperative gallbladder stones;total gastrectomy increase the risk of postoperative gallbladder stones;the higher the degree of lymph node dissection, the greater the risk of postoperative gallbladder stones;there was no statistically significant difference in the incidence of gallbladder stones between pylorus preserving and non pylorus preserving surgery.

关 键 词：胃癌 胃切除术 胆囊结石 危险因素 META分析 

分 类 号：R735.2[医药卫生—肿瘤]