Recurrence of gallstones: a comprehensive multivariate analysis of clinical and biochemical risk factors in a large Chinese cohort of 16,763 patients

Background: Gallstone disease is common, with a prevalence of 5%-22% in Western countries and 6.3%-12.1% in Chinese adults, increasing with age. Postsurgery recurrence is high and analyzing recurrence factors helps identify high-risk patients and preventive strategies. This study explores the differences in stone types and factors associated with postoperative recurrence.

Method: Data from 16,763 patients treated for gallstones at Shandong Third Hospital (2017-2023) were collected. Variables such as age, gender, stone type and size, comorbidities and biochemical results were analyzed using rank sum test, chi-square test, odds ratio (OR) and logistic regression.

Results: Among 16,763 patients, females were slightly more numerous, with ages predominantly in the 60-74 range. Gallbladder stones were the most common type, with a low recurrence rate. Recurrence was significantly associated with stone size, venous thrombosis, respiratory diseases, and cirrhosis. Different stone types varied in terms of complications, gender, age, and recurrence.

Conclusions: Different stone types varied by comorbidities, gender, age, and recurrence, influencing recurrence risk. While the direct effect of stone type on recurrence is unclear, comorbidities play a crucial role. Larger, multicenter studies are needed to improve treatment guidance.