摘要
目的:探讨腹腔镜胆总管囊肿手术后胆漏的相关因素及治疗措施。方法:回顾分析2011年6月至2016年6月收治的103例腹腔镜胆总管囊肿切除术患者的临床资料,按是否发生胆漏分为两组,分析可能影响胆漏发生的因素,并通过单因素、多因素分析确定其危险因素,分析胆漏的治疗策略。结果:术后17例(16.50%)发生胆漏,经保守治疗或再次手术后胆漏消失。单因素分析显示,患者体重指数(χ~2=4.027,P=0.045)、术前血浆白蛋白(χ~2=4.156,P=0.041)、术前总胆红素(χ~2=4.374,P=0.035)为胆总管囊肿术后发生胆漏的危险因素;而患者年龄、性别、手术时间、术中出血量等不是胆总管囊肿术后胆漏的危险因素(P>0.05)。多因素logistic回归分析结果显示,术前血浆白蛋白(β=1.371,P=0.012,OR=2.638)、体重指数(β=1.760,P<0.01,OR=8.171)是胆漏发生的独立危险因素。结论:在胆总管囊肿术后发生胆漏的影响因素中,体重指数、术前血浆白蛋白是独立危险因素。
Objective ： To explore the relative influencing factors and treatment strategy of bile leakage after laparoscopic chole- dochal cyst excision. Methods：The clinical data of 103 patients who underwent laparoscopic eholedochal cyst excision from Jun. 2011 to Jun. 2016 were retrospectively analyzed. All patients were divided into two groups according to whether they had the bile leakage, the factors which might influence the occurrence of bile leakage were analyzed. The risk factors were identified through the single factor and multi-factor analysis and the treatment strategy of bile leakage was analyzed. Results：After laparoscopic choledochal cyst excision, 17 patients （ 16.50% ） suffered from bile leakage, and bile leakage disappeared after the conservative treatment or reoperation. Single-fac- tor analysis showed that body mass index （ χ2= 4. 027, P = 0. 045 ） , preoperative plasma albumin （ χ2 = 4.156, P = 0.041 ）, preopera- tive total bilirubin （χ2= 4. 374,P = 0. 035 ） were risk factors for bile leakage, while the patients＇age, gender, operative time and intrao- perative bleeding volume were not （ P 〉 0.05 ）. Multi-factor logistic regression analysis showed that preoperative plasma albumin （ β = 1. 371, P = 0. 012, OR = 2. 638 ） and body mass index （ β = 1. 760,P 〈 0. 01, OR = 8. 171 ） were the independent risk factors. Conclusions：In the influence factors of bile leakage after laparoscopic choledochal cyst excision, body mass index and preoperative plasma al- bumin are independent risk factors.
作者
马吉安
刘维政
谭孝华
邹华
贾学峰
MA Ji-an;LIU Wei-zheng;TAN Xiao-hua;et al(Department of Hepatobiliary Surgery, Traditional Chinese and Western Medicine Integrated Hospital of Dazhou, Dazhou 635000, Chin)
出处
《腹腔镜外科杂志》
2017年第9期665-668,共4页
Journal of Laparoscopic Surgery
关键词
胆总管囊肿
腹腔镜检查
胆漏
因素分析
统计学
Choledochal cyst
Laparoscopy
Bile leakage
Factor analysis, statistical
