摘要
目的:探讨影响腹腔镜手术治疗胆囊结石合并胆总管结石疗效的相关因素。方法:回顾分析2009年6月至2011年6月为128例胆囊结石合并胆总管结石患者行腹腔镜手术的临床资料,根据患者术后是否复发将其分为复发组及未复发组,分别采用单因素及Logistic回归模型分析影响胆囊结石合并胆总管结石术后复发的相关因素。结果:24例术后复发,复发率18.75%。经单因素分析得出,年龄、胆总管直径、结石数量、胆总管扩张、胆囊管扩张、胆管炎、总胆红素异常、胰腺炎、结石残留、术后合并症、黄疸、结石直径及手术类型与胆囊结石合并胆总管结石术后复发相关。经Logistic回归模型分析可知,胆总管直径、胆囊管扩张、胆总管扩张、结石数量、胆管炎、结石残留、术后合并症及手术类型是影响胆囊结石合并胆总管结石患者术后复发的独立危险因素。结论:腹腔镜手术治疗胆囊结石合并胆总管结石术后复发的影响因素较多,临床应根据患者具体情况制定相应的预防控制措施,以降低术后复发率。
Objective：To analyze the factors influencing the efficacy of laparoscopic surgeries in treating patients with both gallbladder and common bile duct stones. Methods：The clinical data of 128 patients with both gallbladder and common bile duet stones were retrospectively analyzed from Jun. 2009 to Jun. 2011. The patients were divided into recurrence group and non-recurrence group. The recurrence relevant factors were analyzed with univariate analysis and Logistic regression. Results：Twenty-four eases showed recur- rence. The recurrence rate was 18.75 %. The univariate analysis showed that age, common bile duct diameter, number of stones, common bile duct dilatation, cystic duet dilatation, cholangitis, total bilirubin abnormity, pancreatitis, residual stones, postoperative complications, jaundice, stone diameter and type of surgery were related to recurrence. The Logistic regression showed that diameter of the common bile duct, cystic duct dilatation, common bile duct dilatation,number of stones, cholangitis, residual stones, postoperative complications and type of surgery were the independent risk factors of recurrence. Conclusions： Recurrence of gallbladder stones and common bile duct stones after laparoscopic surgery is caused by a number of factors. Appropriate prevention and control strategies should be developed to reduce the recurrence rate.
出处
《腹腔镜外科杂志》
2014年第5期332-335,共4页
Journal of Laparoscopic Surgery
关键词
胆囊结石病
胆总管结石
腹腔镜检查
复发
Cholecystolithiasis
Choledocholithiasis
Laparoscopy
Recurrence
