This article aims to deepen the understanding of the role of Helicobacter pylori(H.pylori)infection in the development of cholelithiasis,initiated by the article by Yao et al,who investigated the potential link betwee...This article aims to deepen the understanding of the role of Helicobacter pylori(H.pylori)infection in the development of cholelithiasis,initiated by the article by Yao et al,who investigated the potential link between H.pylori infection and the development of cholelithiasis through a multicenter retrospective study on an Asian population of over 70000 participants.They also performed a compre-hensive analysis of previously published studies on H.pylori and cholelithiasis,finding a positive association therein[odds ratio(OR)=1.103,P=0.049].Patients positive for H.pylori also had lower levels of total and direct bilirubin,but higher levels of total cholesterol and low-density lipoprotein cholesterol compared to uninfected patients(P<0.05).Cohort studies have confirmed that H.pylori is a risk factor for cholelithiasis(P<0.0001),and aggregate analyses of case-control and cross-sectional studies have shown a positive association between H.pylori and cholelithiasis in Asia(OR=1.599,P=0.034),but not in Europe(OR=1.277,P=0.246).Moreover,H.pylori appears to be related to a higher ratio of choledocho-lithiasis/cholecystolithiasis(OR=3.321,P=0.033).The authors conclude that H.pylori infection is positively correlated with cholelithiasis,particularly with the choledocholithiasis phenotype,especially in Asia,and it is potentially related to bilirubin and cholesterol metabolism.展开更多
Dear Editor,Observational studies in epidemiology have identified a correlation between hypothyroidism and cholelithiasis[1–2].However,the causal relationship between the two diseases remains unclear.To investigate t...Dear Editor,Observational studies in epidemiology have identified a correlation between hypothyroidism and cholelithiasis[1–2].However,the causal relationship between the two diseases remains unclear.To investigate the potential causal relationship,we employed a two-sample bidirectional Mendelian randomization(MR)analysis.展开更多
BACKGROUND Helicobacter pylori(H.pylori)is a prevalent pathogen associated with various diseases.Cholelithiasis is also a common condition.H.pylori infection has been identified in the biliary system,suggesting its po...BACKGROUND Helicobacter pylori(H.pylori)is a prevalent pathogen associated with various diseases.Cholelithiasis is also a common condition.H.pylori infection has been identified in the biliary system,suggesting its potential involvement in biliary diseases.However,the specific role of H.pylori in the development of cholelithiasis remains inconclusive.AIM To investigate the potential association between H.pylori infection and the development of cholelithiasis.METHODS We performed a retrospective study in more than 70000 subjects in health examination center from 3 institutions in the middle,northern and eastern China,from October 2018 to December 2021,to explore the potential association between H.pylori and cholelithiasis through univariate and multivariate analysis.Meanwhile,the influence of H.pylori on biliary-related parameters was investigated.A comprehensive analysis of previous studies concerned about H.pylori and cholelithiasis was also executed.RESULTS In our multi-center study,H.pylori was positively associated with cholelithiasis[odds ratio(OR)=1.103,95%confidence interval(CI):1.001-1.216,P=0.049].Furthermore,H.pylori patients had less total and direct bilirubin than uninfected patients,while the total cholesterol and low-density lipoprotein cholesterol were more in H.pyloripositive participants(P<0.05).In the published articles,the cohort studies indicated H.pylori was a risk factor of cholelithiasis(hazard ratio=1.3280,95%CI:1.1810-1.4933,P<0.0001).The pooled results of case-control and crosssectional studies showed positive association between H.pylori and cholelithiasis in Asia(OR=1.5993,95%CI:1.0353-2.4706,P=0.034)but not in Europe(OR=1.2770,95%CI:0.8446-1.9308,P=0.246).Besides,H.pylori was related to a higher choledocholithiasis/cholecystolithiasis ratio(OR=3.3215,95%CI:1.1034-9.9986,P=0.033).CONCLUSION H.pylori is positively correlated with cholelithiasis,choledocholithiasis phenotype particularly,especially in Asia,which may be relevant to bilirubin/cholesterol metabolism.Cohort studies confirm an increased risk of cholelithiasis in H.pylori patients.展开更多
BACKGROUND Education,cognition,and intelligence are associated with cholelithiasis occurrence,yet which one has a prominent effect on cholelithiasis and which cardiometabolic risk factors mediate the causal relationsh...BACKGROUND Education,cognition,and intelligence are associated with cholelithiasis occurrence,yet which one has a prominent effect on cholelithiasis and which cardiometabolic risk factors mediate the causal relationship remain unelucidated.AIM To explore the causal associations between education,cognition,and intelligence and cholelithiasis,and the cardiometabolic risk factors that mediate the associations.METHODS Applying genome-wide association study summary statistics of primarily European individuals,we utilized two-sample multivariable Mendelian randomization to estimate the independent effects of education,intelligence,and cognition on cholelithiasis and cholecystitis(FinnGen study,37041 and 11632 patients,respectively;n=486484 participants)and performed two-step Mendelian randomization to evaluate 21 potential mediators and their mediating effects on the relationships between each exposure and cholelithiasis.RESULTS Inverse variance weighted Mendelian randomization results from the FinnGen consortium showed that genetically higher education,cognition,or intelligence were not independently associated with cholelithiasis and cholecystitis;when adjusted for cholelithiasis,higher education still presented an inverse effect on cholecystitis[odds ratio:0.292(95%CI:0.171-0.501)],which could not be induced by cognition or intelligence.Five out of 21 cardiometabolic risk factors were perceived as mediators of the association between education and cholelithiasis,including body mass index(20.84%),body fat percentage(40.3%),waist circumference(44.4%),waist-to-hip ratio(32.9%),and time spent watching television(41.6%),while time spent watching television was also a mediator from cognition(20.4%)and intelligence to cholelithiasis(28.4%).All results were robust to sensitivity analyses.CONCLUSION Education,cognition,and intelligence all play crucial roles in the development of cholelithiasis,and several cardiometabolic mediators have been identified for prevention of cholelithiasis due to defects in each exposure.展开更多
Biliary complications like cholelithiasis and choledocholithiasis are more common in bariatric surgery patients due to obesity and rapid weight loss.Patients with a body mass index>40 face an eightfold risk of deve...Biliary complications like cholelithiasis and choledocholithiasis are more common in bariatric surgery patients due to obesity and rapid weight loss.Patients with a body mass index>40 face an eightfold risk of developing cholelithiasis.Postbariatric surgery,especially after laparoscopic Roux-en-Y gastric bypass(LRYGB),30%of patients develop biliary disease due to rapid weight loss.The aim of this review is to analyze the main biliary complications that occur after bariatric surgery and its management.A review of the literature was conducted mainly from 2010 up to 2023 with regard to biliary complications associated with bariatric patients in SciELO,PubMed,and MEDLINE.Patients undergoing LRYGB have a higher incidence(14.5%)of symptomatic calculi post-surgery compared to those undergoing laparoscopic sleeve gastrectomy at 4.1%.Key biliary complications within 6 to 12 months post-surgery include:Cholelithiasis:36%;Biliary colic/dyskinesia:3.86%;Acute cholecystitis:0.98%-18.1%;Chronic cholecystitis:70.2%;Choledocholithiasis:0.2%-5.7%and Pancreatitis:0.46%-9.4%.Surgeons need to be aware of these complications and consider surgical treatments based on patient symptoms to enhance their quality of life.展开更多
Objective:To evaluate the therapeutic effect of laparoscopic cholecystectomy(LC)and open cholecystectomy(OC)on cholelithiasis.Methods:92 cases of cholelithiasis patients admitted to the hospital in the past 2 years we...Objective:To evaluate the therapeutic effect of laparoscopic cholecystectomy(LC)and open cholecystectomy(OC)on cholelithiasis.Methods:92 cases of cholelithiasis patients admitted to the hospital in the past 2 years were selected and grouped by random number table;the observation group was treated with LC;the reference group was treated with OC,and the inflammatory factor and other indexes were compared.Results:The total effective rate of the observation group was higher than that of the reference group,and the perioperative indexes were better than that of the reference group(P<0.05).Preoperatively,the C-reactive protein(CRP)and interleukin-1β(IL-1β)levels and immune function indexes of the two groups were compared,and no difference was seen(P>0.05).At 5 days postoperatively,the CRP and IL-1βlevels of the observation group were lower than those of the reference group,and the immune function indicators were higher than those of the reference group(P<0.05).The complication rate of the observation group was lower than that of the reference group(P<0.05).Conclusion:LC can increase the effective rate of cholelithiasis patients,improve their perioperative indexes,reduce the inflammatory response,protect patients’immune function,and ensure higher surgical safety.展开更多
BACKGROUND Mirizzi syndrome is a rare complication of chronic gallstone disease in which an impacted stone causes compression or erosion of the common hepatic duct.Accurate preoperative diagnosis is crucial but often ...BACKGROUND Mirizzi syndrome is a rare complication of chronic gallstone disease in which an impacted stone causes compression or erosion of the common hepatic duct.Accurate preoperative diagnosis is crucial but often challenging.We report a case that was preoperatively diagnosed as type 1 Mirizzi syndrome but was found intraoperatively to be type 4,involving a cholecysto-biliary fistula and complete erosion of the common hepatic duct.CASE SUMMARY A 74-year-old woman presented with right upper quadrant discomfort.Initial workup including ultrasound and magnetic resonance cholangiopancreatography suggested Mirizzi syndrome type 1 due to extrinsic compression of the common hepatic duct.Endoscopic retrograde cholangiopancreatography confirmed a large stone without evidence of fistula.The patient underwent robotic-assisted cholecystectomy,during which a 4 cm stone was found eroding into the common hepatic duct,consistent with type 4 Mirizzi syndrome.Intraoperative cholangioscopy confirmed the fistula and allowed primary repair.The patient recovered uneventfully and was discharged on postoperative day one.CONCLUSION Preoperative imaging may fail to identify fistula formation in Mirizzi syndrome.Intraoperative assessment remains critical for accurate diagnosis and safe surgical management.展开更多
文摘This article aims to deepen the understanding of the role of Helicobacter pylori(H.pylori)infection in the development of cholelithiasis,initiated by the article by Yao et al,who investigated the potential link between H.pylori infection and the development of cholelithiasis through a multicenter retrospective study on an Asian population of over 70000 participants.They also performed a compre-hensive analysis of previously published studies on H.pylori and cholelithiasis,finding a positive association therein[odds ratio(OR)=1.103,P=0.049].Patients positive for H.pylori also had lower levels of total and direct bilirubin,but higher levels of total cholesterol and low-density lipoprotein cholesterol compared to uninfected patients(P<0.05).Cohort studies have confirmed that H.pylori is a risk factor for cholelithiasis(P<0.0001),and aggregate analyses of case-control and cross-sectional studies have shown a positive association between H.pylori and cholelithiasis in Asia(OR=1.599,P=0.034),but not in Europe(OR=1.277,P=0.246).Moreover,H.pylori appears to be related to a higher ratio of choledocho-lithiasis/cholecystolithiasis(OR=3.321,P=0.033).The authors conclude that H.pylori infection is positively correlated with cholelithiasis,particularly with the choledocholithiasis phenotype,especially in Asia,and it is potentially related to bilirubin and cholesterol metabolism.
基金by grants from the Jiangsu Province 333 High-level Talent Training Project(Grant No.LGY2016010)the Nanjing Science and Technology Development Plan(Grant No.201715003)the Jiangsu Province Six Talent Peaks(Grant No.WSN-030).
文摘Dear Editor,Observational studies in epidemiology have identified a correlation between hypothyroidism and cholelithiasis[1–2].However,the causal relationship between the two diseases remains unclear.To investigate the potential causal relationship,we employed a two-sample bidirectional Mendelian randomization(MR)analysis.
基金Supported by the National Natural Science Foundation of China,No.82270594the National Natural Science Foundation for Youths of China,No.82103151+1 种基金the Outstanding Youth Foundation of Hunan Province,No.2022JJ20092the Wisdom Accumulation and Talent Cultivation Project of Third Xiangya Hospital of Central South University,No.YX202103.
文摘BACKGROUND Helicobacter pylori(H.pylori)is a prevalent pathogen associated with various diseases.Cholelithiasis is also a common condition.H.pylori infection has been identified in the biliary system,suggesting its potential involvement in biliary diseases.However,the specific role of H.pylori in the development of cholelithiasis remains inconclusive.AIM To investigate the potential association between H.pylori infection and the development of cholelithiasis.METHODS We performed a retrospective study in more than 70000 subjects in health examination center from 3 institutions in the middle,northern and eastern China,from October 2018 to December 2021,to explore the potential association between H.pylori and cholelithiasis through univariate and multivariate analysis.Meanwhile,the influence of H.pylori on biliary-related parameters was investigated.A comprehensive analysis of previous studies concerned about H.pylori and cholelithiasis was also executed.RESULTS In our multi-center study,H.pylori was positively associated with cholelithiasis[odds ratio(OR)=1.103,95%confidence interval(CI):1.001-1.216,P=0.049].Furthermore,H.pylori patients had less total and direct bilirubin than uninfected patients,while the total cholesterol and low-density lipoprotein cholesterol were more in H.pyloripositive participants(P<0.05).In the published articles,the cohort studies indicated H.pylori was a risk factor of cholelithiasis(hazard ratio=1.3280,95%CI:1.1810-1.4933,P<0.0001).The pooled results of case-control and crosssectional studies showed positive association between H.pylori and cholelithiasis in Asia(OR=1.5993,95%CI:1.0353-2.4706,P=0.034)but not in Europe(OR=1.2770,95%CI:0.8446-1.9308,P=0.246).Besides,H.pylori was related to a higher choledocholithiasis/cholecystolithiasis ratio(OR=3.3215,95%CI:1.1034-9.9986,P=0.033).CONCLUSION H.pylori is positively correlated with cholelithiasis,choledocholithiasis phenotype particularly,especially in Asia,which may be relevant to bilirubin/cholesterol metabolism.Cohort studies confirm an increased risk of cholelithiasis in H.pylori patients.
文摘BACKGROUND Education,cognition,and intelligence are associated with cholelithiasis occurrence,yet which one has a prominent effect on cholelithiasis and which cardiometabolic risk factors mediate the causal relationship remain unelucidated.AIM To explore the causal associations between education,cognition,and intelligence and cholelithiasis,and the cardiometabolic risk factors that mediate the associations.METHODS Applying genome-wide association study summary statistics of primarily European individuals,we utilized two-sample multivariable Mendelian randomization to estimate the independent effects of education,intelligence,and cognition on cholelithiasis and cholecystitis(FinnGen study,37041 and 11632 patients,respectively;n=486484 participants)and performed two-step Mendelian randomization to evaluate 21 potential mediators and their mediating effects on the relationships between each exposure and cholelithiasis.RESULTS Inverse variance weighted Mendelian randomization results from the FinnGen consortium showed that genetically higher education,cognition,or intelligence were not independently associated with cholelithiasis and cholecystitis;when adjusted for cholelithiasis,higher education still presented an inverse effect on cholecystitis[odds ratio:0.292(95%CI:0.171-0.501)],which could not be induced by cognition or intelligence.Five out of 21 cardiometabolic risk factors were perceived as mediators of the association between education and cholelithiasis,including body mass index(20.84%),body fat percentage(40.3%),waist circumference(44.4%),waist-to-hip ratio(32.9%),and time spent watching television(41.6%),while time spent watching television was also a mediator from cognition(20.4%)and intelligence to cholelithiasis(28.4%).All results were robust to sensitivity analyses.CONCLUSION Education,cognition,and intelligence all play crucial roles in the development of cholelithiasis,and several cardiometabolic mediators have been identified for prevention of cholelithiasis due to defects in each exposure.
基金The authors have read the PRISMA 2009 Checklist,and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
文摘Biliary complications like cholelithiasis and choledocholithiasis are more common in bariatric surgery patients due to obesity and rapid weight loss.Patients with a body mass index>40 face an eightfold risk of developing cholelithiasis.Postbariatric surgery,especially after laparoscopic Roux-en-Y gastric bypass(LRYGB),30%of patients develop biliary disease due to rapid weight loss.The aim of this review is to analyze the main biliary complications that occur after bariatric surgery and its management.A review of the literature was conducted mainly from 2010 up to 2023 with regard to biliary complications associated with bariatric patients in SciELO,PubMed,and MEDLINE.Patients undergoing LRYGB have a higher incidence(14.5%)of symptomatic calculi post-surgery compared to those undergoing laparoscopic sleeve gastrectomy at 4.1%.Key biliary complications within 6 to 12 months post-surgery include:Cholelithiasis:36%;Biliary colic/dyskinesia:3.86%;Acute cholecystitis:0.98%-18.1%;Chronic cholecystitis:70.2%;Choledocholithiasis:0.2%-5.7%and Pancreatitis:0.46%-9.4%.Surgeons need to be aware of these complications and consider surgical treatments based on patient symptoms to enhance their quality of life.
文摘Objective:To evaluate the therapeutic effect of laparoscopic cholecystectomy(LC)and open cholecystectomy(OC)on cholelithiasis.Methods:92 cases of cholelithiasis patients admitted to the hospital in the past 2 years were selected and grouped by random number table;the observation group was treated with LC;the reference group was treated with OC,and the inflammatory factor and other indexes were compared.Results:The total effective rate of the observation group was higher than that of the reference group,and the perioperative indexes were better than that of the reference group(P<0.05).Preoperatively,the C-reactive protein(CRP)and interleukin-1β(IL-1β)levels and immune function indexes of the two groups were compared,and no difference was seen(P>0.05).At 5 days postoperatively,the CRP and IL-1βlevels of the observation group were lower than those of the reference group,and the immune function indicators were higher than those of the reference group(P<0.05).The complication rate of the observation group was lower than that of the reference group(P<0.05).Conclusion:LC can increase the effective rate of cholelithiasis patients,improve their perioperative indexes,reduce the inflammatory response,protect patients’immune function,and ensure higher surgical safety.
文摘BACKGROUND Mirizzi syndrome is a rare complication of chronic gallstone disease in which an impacted stone causes compression or erosion of the common hepatic duct.Accurate preoperative diagnosis is crucial but often challenging.We report a case that was preoperatively diagnosed as type 1 Mirizzi syndrome but was found intraoperatively to be type 4,involving a cholecysto-biliary fistula and complete erosion of the common hepatic duct.CASE SUMMARY A 74-year-old woman presented with right upper quadrant discomfort.Initial workup including ultrasound and magnetic resonance cholangiopancreatography suggested Mirizzi syndrome type 1 due to extrinsic compression of the common hepatic duct.Endoscopic retrograde cholangiopancreatography confirmed a large stone without evidence of fistula.The patient underwent robotic-assisted cholecystectomy,during which a 4 cm stone was found eroding into the common hepatic duct,consistent with type 4 Mirizzi syndrome.Intraoperative cholangioscopy confirmed the fistula and allowed primary repair.The patient recovered uneventfully and was discharged on postoperative day one.CONCLUSION Preoperative imaging may fail to identify fistula formation in Mirizzi syndrome.Intraoperative assessment remains critical for accurate diagnosis and safe surgical management.
