摘要
目的:探讨中国腹腔镜胆囊切除胆管损伤的危险因素。方法:检索PubMed、EMBASE、中国知网、万方数据库、维普网数据库,收集1992—2020年公开发表的中国腹腔镜胆囊切除胆管损伤危险因素病例对照研究,使用Revman5.3进行荟萃分析,用OR值和95%CI分析结果。结果:包括20项病例对照研究,共纳入41134例患者,466例患者腹腔镜胆囊切除时发生胆管损伤,胆管损伤的发生率为1.13%。胆管损伤的危险因素包括年龄(≥40岁)、术前肝功能异常、白蛋白(<40 g/L)、胆囊壁厚度(≥4 mm)、胆囊急性炎及亚急性炎症、胆囊结石合并积液、胆囊三角解剖变异。结论:年龄(≥40岁)、胆囊壁厚度(≥4 mm)、术前肝功能异常、白蛋白(<40 g/L)、胆囊急性炎及亚急性炎症、胆囊结石合并积液、胆囊三角解剖变异是腹腔镜胆囊切除胆管损伤的危险因素,需早期识别这些危险因素,提高手术的安全意识,避免胆管损伤的发生。
Objective:To investigate the risk factors of bile duct injury in laparoscopic cholecystectomy in China by meta-analysis.Methods:PubMed,EMBASE,cnki,wanfang database and VIP database were searched to collect the published case-control studies on risk factors of bile duct injury in laparoscopic cholecystotomy in China from 1992 to 2020.Meta-analysis was performed using Revman5.3,and the results were analyzed with OR value and 95%CI.Results:A total of 41,134 patients were included in 20 case-control studies,and 466 patients developed bile duct injury during laparoscopic cholecystectomy,with an incidence of 1.13%.Risk factors for bile duct injury include age(40 years),abnormal liver function before operation,albumin(<40g/L),gallbladder wall thickness(4 mm),acute and subacute inflammation of gallbladder,,gallbladder calculus with effusion,gallbladder triangle anatomical variation).Gender and overweight(BMI≥25 kg/m2)had no correlation with the occurrence of bile duct injury after laparoscopic cholecystectomy.Conclusion:Age(≥40 years old),the gallbladder wall thickness(4 mm),preoperative liver function is abnormal,albumin(<40 g/L),gallbladder acute and subacute inflammation,gallbladder stone with effusion,gallbladder triangle anatomical variations of laparoscopic gallbladder excision of bile duct injury risk factors,early recognition of these risk factors,increase the safety awareness of the operation,avoid the happening of bile duct injury.
作者
杨少华
胡晟
洪茂林
张小文
YANG Shao-hua;HU Sheng;HONG Mao-lin;ZHANG Xiao-wen(Department of Hepatobiliary and Pancreatic Surgery,The Second Affiliated Hospital of Kunming Medical University,Kunming 650101,China)
出处
《中国现代普通外科进展》
CAS
2022年第9期694-701,共8页
Chinese Journal of Current Advances in General Surgery
基金
云南省万人计划“名医”培养基金资助项目(云人社[2018]73号)。
关键词
腹腔镜胆囊切除术
胆管损伤
危险因素
中国
Laparoscopic cholecystectomy
Bile duct injury
Risk factors
China
