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| Development and validation of a nomogram model for predicting the risk of gallstone recurrence after gallbladder-preserving surgery |
| Peng Liu a , b , c , # , Yong-Wei Chen a , b , c , # , Che Liu a , b , c , Yin-Tao Wu a , b , c , Wen-Chao Zhao a , b , c , Jian-Yong Zhu a , b , c , Yang An a , b , c , Nian-Xin Xia a , b , c , ∗ |
a Faculty of Hepato-Pancreato-Biliary Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
b Institute of Hepatobiliary Surgery of Chinese PLA, Beijing 100853, China
c Key Laboratory of Digital Hepetobiliary Surgery of Chinese PLA, Beijing 100853, China
∗Corresponding author at: Faculty of Hepato-Pancreato-Biliary Surgery, the First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing 100853, China.
E-mail address: doctorxnx@163.com (N.-X. Xia).
# Contributed equally. |
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Abstract Background: The high incidence of gallstone recurrence was a major concern for laparoscopic gallbladder-preserving surgery. This study aimed to investigate the risk factors for gallstone recurrence after gallbladder-preserving surgery and to establish an individualized nomogram model to predict the risk of gallstone recurrence.
Methods: The clinicopathological and follow-up data of 183 patients who were initially diagnosed with gallstones and treated with gallbladder-preserving surgery at our hospital from January 2012 to January 2019 were retrospectively collected. The independent predictive factors for gallstone recurrence following gallbladder-preserving surgery were identified by multivariate logistic regression analysis. A nomogram model for the prediction of gallstone recurrence was constructed based on the selected variables. The C-index, receiver operating characteristic (ROC) curve and calibration curve were used to evaluate the predictive power of the nomogram model for gallstone recurrence.
Results: During the follow-up period, a total of 65 patients experienced gallstone recurrence, and the recurrence rate was 35.5%. Multivariate logistic regression analysis revealed that the course of gallstones > 2 years [odds ratio (OR) = 2.567, 95% confidence interval (CI): 1.270-5.187, P = 0.009], symptomatic gallstones (OR = 2.589, 95% CI: 1.059-6.329, P = 0.037), multiple gallstones (OR = 2.436, 95% CI: 1.133- 5.237, P = 0.023), history of acute cholecystitis (OR = 2.778, 95% CI: 1.178-6.549, P = 0.020) and a greasy diet (OR = 2.319, 95% CI: 1.186-4.535, P = 0.014) were independent risk factors for gallstone recurrence after gallbladder-preserving surgery. A nomogram model for predicting the recurrence of gallstones was established based on the above five variables. The results showed that the C-index of the nomogram model was 0.692, suggesting it was valuable to predict gallstone recurrence. Moreover, the calibration curve showed good consistency between the predicted probability and actual probability.
Conclusions: The nomogram model for the prediction of gallstone recurrence might help clinicians de- velop a proper treatment strategy for patients with gallstones. Gallbladder-preserving surgery should be cautiously considered for patients with high recurrence risks.
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2024, Vol. 23 
