Gallstone recurrence after successful lithotripsy

Pelletier, G; Raymond, Jean-Michel; Capdeville, R; Mosnier, H; Caroli-Bosc, François-Xavier

doi:10.1016/0168-8278(95)80200-2

Cited by 18 publications

(9 citation statements)

References 20 publications

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“…The Finnish population, for example, differs from the Dutch population in apoE allele fre-number of initial gallstones. We and others 19,48 could not confirm these findings because we found a concordance in less quency both by a lower E2 and a higher E4 frequency. 21 Population differences might explain why apoE distribution in than onehalf of the cases.…”

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confidence: 56%

“…Previous postdissolution trials yielded similar conclusions. 3,13,18,48 We found that, although women The most intriguing finding in our study is that the recurrence of cholesterol gallstones might be at least in part ex-who had previously been pregnant tended to be overrepresented in the group with recurrence as compared with the plained by genetic factors, such as apoE polymorphism. We found a 2.4-fold increase in the recurrence rate of cholesterol group without recurrence, differences were not significant.…”

Section: Aid Hepa 0041mentioning

confidence: 51%

“…3,18,45 After ESWL, this was the case in a study from .023), and more women on estrogen therapy (P Å .031) than patients with a small residual volume. The large residual one group 47,48 but not from other groups. 13,46 We found that the differences in early recurrence rate with respect to gallgallbladder volume was also associated with a large fasting gallbladder volume and, as expected, with impaired indices stone number disappeared after prolonged follow-up.…”

Section: Fig 4 (A) Fasting and Postprandial Gallbladder Volumes In mentioning

confidence: 99%

“…This finding is in agreement with the Munich studies. 12,13 Other studies have cholesterol saturation index is increased in younger sisters of cholesterol gallstone patients as compared with gallstone-failed to find a high rate of recurrent pain after ESWL [46][47][48] and oral dissolution. 18,44,58 Discrepancies in these observafree controls.…”

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confidence: 99%

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Apolipoprotein E4 Genotype and Gallbladder Motility Influence Speed of Gallstone Clearance and Risk of Recurrence After Extracorporeal Shock–Wave Lithotripsy

Portincasa¹,

Erpecum²,

Meeberg³

et al. 1996

Hepatology

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as well as a high risk of recurrence after ESWL. This Extracorporeal shock-wave lithotripsy (ESWL) is an finding points to a possible role for genetic factors in effective treatment in selected gallstone patients, but the pathogenesis of cholesterol gallstones. Effective gallstone recurrence is a major drawback. Factors potenbladder emptying is important for speed of clearance tially influencing gallstone clearance and recurrence and prevention of recurrence. Patients with initial soliwere studied in 84 patients in whom stone dissolution tary stones have a decreased early-but not long-term was diagnosed after ESWL plus bile salt therapy for inigallstone recurrence rate. (HEPATOLOGY 1996;24:580-tial solitary (n ! 55) or multiple (n ! 29) radiolucent 587.) stones. Apolipoprotein E (apoE) genotyping and gallbladder motility (sonography) were studied in a representative subgroup of patients (n ! 50). The median follow-up after ESWL was 36 months (range, 4.5-67 months).Extracorporeal shock-wave lithotripsy (ESWL) with adjuGallstone clearance was achieved after 8.7 months vant bile salt therapy to dissolve fragments is effective in (range, 0.2-30 months). Independent factors significantly selected patients with gallbladder stones. In the case of solienhancing gallstone clearance were the presence of E4 tary radiolucent gallstones with a diameter°20 mm, comallele; small initial gallstone size and number; effective-plete clearance can be expected in 70% to 80% of patients ness of fragmentation; and good gallbladder emptying after a year of treatment.1,2 Results, however, are consider-(P ! .002). Gallstone recurrence was seen in 30 patients ably less favorable for patients with larger or multiple gallafter 18.6 months (range, 1.0-50 months). Cumulative stones. A major drawback of nonsurgical therapy is the risk gallstone recurrence rate (life-table analysis) was 15% of gallstone recurrence after initially successful treatment. within 1 year, increasing to 60% within 5.5 years. Al-Previous studies on patients treated with oral bile salts sugthough the probability of gallstone recurrence tended gested a 50% recurrence rate at a 5-year follow-up with low or to be smaller in patients with initial solitary stones than no recurrence thereafter. 3,4 The fact that gallstone recurrence in those with multiple stones during early follow-up, dif-occurs in only one half of the patients suggests the existence ferences disappeared after long-term follow-up. Effec-of two subgroups of patients, one with a permanent and the tive gallbladder emptying (residual volume Ù6 mL) and other with a transient defect (e.g., pregnancy, oral contracepapolipoprotein E4 (apoE4) independently influenced tives, postmenopausal estrogens, weight loss in obese pagallstone recurrence. Recurrence rate was higher (log tients, and major abdominal surgery: all considered risk facrank test, P ! .037) in those patients who were homozy-tors for gallstone development). In particular, patients with gous and heterozygous for the E4 allele compared with initially multip...

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contrasting

confidence: 56%

Section: Aid Hepa 0041mentioning

confidence: 51%

Section: Fig 4 (A) Fasting and Postprandial Gallbladder Volumes In mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Apolipoprotein E4 Genotype and Gallbladder Motility Influence Speed of Gallstone Clearance and Risk of Recurrence After Extracorporeal Shock–Wave Lithotripsy

Portincasa¹,

Erpecum²,

Meeberg³

et al. 1996

Hepatology

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show abstract

“…Several studies have examined early stone recurrence after successful lithotripsy (3)(4)(5)(6)(7)(8), but only a few data are available as to the follow-up up to 5.5 years (5,6,(8)(9)(10). Long-term data over 10 years are available only for the postdissolution situation (11,12).…”

mentioning

confidence: 98%