Abstract：
UNASSIGNED: The natural history of symptomatic uncomplicated gallstone disease is largely unknown. We examined the risk of progressing from symptomatic uncomplicated to complicated gallstone disease in a large regional cohort of patients, where disruptions in elective surgical capacities have led to the indefinite postponement of surgery for benign conditions, including cholecystectomies.
UNASSIGNED: Patients with radiologically diagnosed incident symptomatic and uncomplicated gallstone disease were identified from outpatient clinics and emergency departments on the Island of Funen, Denmark. The absolute risk of complications (cholecystitis, cholangitis, pancreatitis, acute cholecystectomy for unremitting pain) was calculated using death and elective cholecystectomies as competing risks using the Aalen-Johansen method. Cox proportional hazards regression analysis was used to estimate hazard ratios (HRs) of gallstone complications associated with patient and gallstone characteristics.
UNASSIGNED: Two hundred eighty-six patients diagnosed with incident symptomatic, uncomplicated gallstone disease from 1 January 2020 to 1 July 2023 were identified. During 79,170 person-years of observation, 176 (61.5%) patients developed a gallstone-related complication. The 6-, 12- and 24-month risk of developing gallstone-related complications were 36%, 55% and 81%. The risk of developing complications related to common bile duct stones was lowest with larger stones (aHR per millimeter increase = 0.89 (0.82-0.97), p < 0.01), while no covariates were statistically significantly associated with the risk of cholecystitis. Eighty-five (30%) patients underwent elective laparoscopic cholecystectomy, with one patient (1.2%) developing a gallstone-related complication afterward.
UNASSIGNED: The risk of developing complications to symptomatic gallstones in a general Scandinavian population is high, and prophylactic cholecystectomy should be considered.
UNASSIGNED: Patients with radiologically diagnosed incident symptomatic and uncomplicated gallstone disease were identified from outpatient clinics and emergency departments on the Island of Funen, Denmark. The absolute risk of complications (cholecystitis, cholangitis, pancreatitis, acute cholecystectomy for unremitting pain) was calculated using death and elective cholecystectomies as competing risks using the Aalen-Johansen method. Cox proportional hazards regression analysis was used to estimate hazard ratios (HRs) of gallstone complications associated with patient and gallstone characteristics.
UNASSIGNED: Two hundred eighty-six patients diagnosed with incident symptomatic, uncomplicated gallstone disease from 1 January 2020 to 1 July 2023 were identified. During 79,170 person-years of observation, 176 (61.5%) patients developed a gallstone-related complication. The 6-, 12- and 24-month risk of developing gallstone-related complications were 36%, 55% and 81%. The risk of developing complications related to common bile duct stones was lowest with larger stones (aHR per millimeter increase = 0.89 (0.82-0.97), p < 0.01), while no covariates were statistically significantly associated with the risk of cholecystitis. Eighty-five (30%) patients underwent elective laparoscopic cholecystectomy, with one patient (1.2%) developing a gallstone-related complication afterward.
UNASSIGNED: The risk of developing complications to symptomatic gallstones in a general Scandinavian population is high, and prophylactic cholecystectomy should be considered.
摘要：
■有症状的无并发症胆结石的自然史在很大程度上是未知的。我们在一个大的区域队列中检查了从症状无并发症到复杂的胆结石疾病进展的风险。选择性手术能力的中断导致良性疾病的手术无限期推迟，包括胆囊切除术.
■从Funen岛的门诊和急诊科发现了放射学诊断为有症状和无并发症的胆结石患者，丹麦。并发症的绝对风险（胆囊炎，胆管炎,胰腺炎,持续疼痛的急性胆囊切除术）使用Aalen-Johansen方法将死亡和选择性胆囊切除术作为竞争风险进行计算。Cox比例风险回归分析用于评估与患者和胆结石特征相关的胆结石并发症的风险比（HRs）。
■二百八十六名被诊断为事件症状的患者，在2020年1月1日至2023年7月1日期间发现了无并发症的胆结石疾病.在79,170人年的观察中，176例（61.5%）患者出现胆结石相关并发症。6-，发生胆结石相关并发症的12个月和24个月风险为36％，55%和81%。发生胆总管结石相关并发症的风险在结石较大时最低(每毫米增加的AHR=0.89(0.82-0.97),p<0.01),而无统计学意义的协变量与胆囊炎风险显著相关.85例（30%）患者行择期腹腔镜胆囊切除术，1例患者（1.2%）随后出现胆结石相关并发症。
■在一般斯堪的纳维亚人群中，出现有症状的胆结石并发症的风险很高，应考虑预防性胆囊切除术。
■从Funen岛的门诊和急诊科发现了放射学诊断为有症状和无并发症的胆结石患者，丹麦。并发症的绝对风险（胆囊炎，胆管炎,胰腺炎,持续疼痛的急性胆囊切除术）使用Aalen-Johansen方法将死亡和选择性胆囊切除术作为竞争风险进行计算。Cox比例风险回归分析用于评估与患者和胆结石特征相关的胆结石并发症的风险比（HRs）。
■二百八十六名被诊断为事件症状的患者，在2020年1月1日至2023年7月1日期间发现了无并发症的胆结石疾病.在79,170人年的观察中，176例（61.5%）患者出现胆结石相关并发症。6-，发生胆结石相关并发症的12个月和24个月风险为36％，55%和81%。发生胆总管结石相关并发症的风险在结石较大时最低(每毫米增加的AHR=0.89(0.82-0.97),p<0.01),而无统计学意义的协变量与胆囊炎风险显著相关.85例（30%）患者行择期腹腔镜胆囊切除术，1例患者（1.2%）随后出现胆结石相关并发症。
■在一般斯堪的纳维亚人群中，出现有症状的胆结石并发症的风险很高，应考虑预防性胆囊切除术。
