Velamazán R, López-Guillén P, Martínez-Domínguez SJ, Abad Baroja D, Oyón D, Arnau A, Ruiz-Belmonte LM, Tejedor-Tejada J, Zapater R, Martín-Vicente N, Fernández-Esparcia PJ, Julián Gomara AB, Sastre Lozano V, Manzanares García JJ, Chivato Martín-Falquina I, Andrés Pascual L, Torres Monclus N, Zaragoza Velasco N, Rojo E, Lapeña-Muñoz B, Flores V, Díaz Gómez A, Cañamares-Orbís P, Vinzo Abizanda I, Marcos Carrasco N, Pardo Grau L, García-Rayado G, Millastre Bocos J, Garcia Garcia de Paredes A, Vaamonde Lorenzo M, Izagirre Arostegi A, Lozada-Hernández EE, Velarde-Ruiz Velasco JA, and de-Madaria E
Background: Delayed cholecystectomy in patients with symptomatic gallstone disease is associated with recurrence. Limited data on the recurrence patterns and the factors that determine them are available., Objective: We aimed to determine the pattern of relapse in each symptomatic gallstone disease (acute pancreatitis, cholecystitis, cholangitis, symptomatic choledocholithiasis, and biliary colic) and determine the associated factors., Methods: RELAPSTONE was an international multicenter retrospective cohort study. Patients (n = 3016) from 18 tertiary centers who suffered a first episode of symptomatic gallstone disease from 2018 to 2020 and had not undergone cholecystectomy during admission were included. The main outcome was relapse-free survival. Kaplan-Meier curves were used in the bivariate analysis. Multivariable Cox regression models were used to identify prognostic factors associated with relapses., Results: Mean age was 76.6 [IQR: 59.7-84.1], and 51% were male. The median follow-up was 5.3 months [IQR 2.1-12.4]. Relapse-free survival was 0.79 (95% CI: 0.77-0.80) at 3 months, 0.71 (95% CI: 0.69-0.73) at 6 months, and 0.63 (95% CI: 0.61-0.65) at 12 months. In multivariable analysis, older age (HR = 0.57; 95% CI: 0.49-0.66), sphincterotomy (HR = 0.58, 95% CI: 0.49-0.68) and higher leukocyte count (HR = 0.79; 95% CI: 0.70-0.90) were independently associated with lower risk of relapse, whereas higher levels of alanine aminotransferase (HR = 1.22; 95% CI: 1.02-1.46) and multiple cholelithiasis (HR = 1.19, 95% CI: 1.05-1.34) were associated with higher relapse rates., Conclusion: The relapse rate is high and different in each symptomatic gallstone disease. Our independent predictors could be useful for prioritizing patients on the waiting list for cholecystectomies., (© 2024 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.)