摘要
目的:探讨胆囊结石合并胆总管结石(CBDS)术后患者复发情况及危险因素。方法:纳入2019年1月至2020年12月行内镜下逆行胰胆管造影术(ECRP)联合腹腔镜胆囊切除术(LC)治疗的胆囊结石合并CBDS患者114例,根据术后随访1年内是否复发(REC)分为REC组(32例)和未REC组(82例)。回顾性统计胆囊结石合并CBDS术后患者REC情况,比较REC组和未REC组的临床资料,并分析胆囊结石合并CBDS术后患者REC的危险因素。结果:114例胆囊结石合并CBDS术后患者出现REC为32例,发生率为28.07%。胆囊结石合并CBDS术后患者REC的危险因素为胆道感染、胆道口括约肌切开、术者经验≤3年、胆道括约肌功能障碍(OR=4.170、4.047、3.568、3.367,P<0.05)。结论:胆囊结石合并CBDS术后患者REC的危险因素为胆道感染、胆道口括约肌切开、术者经验≤3年、胆道括约肌功能障碍,可据此针对性制定干预措施,以降低胆囊结石合并CBDS术后患者的REC率。
Objective:To investigate the recurrence and risk factors of postoperative patients with cholecystolithiasis complicated with common bile duct stones(CBDS).Methods:From January 2019 to December 2020,114 patients with cholecystolithiasis complicated with CBDS who underwent endoscopic retrograde cholangiopancreatography(ECRP)combined with laparoscopic cholecystectomy(LC)were included.According to whether there was recurrence(REC)within 1 year after surgery,they were divided into REC group(32 cases)and non REC group(82 cases).The REC status of patients with cholecystolithiasis combined with CBDS was analyzed retrospectively,the clinical data of REC group and non REC group were compared,and the risk factors of REC in patients with cholecystolithiasis combined with CBDS after operation were analyzed.Results:Among 114 cases of cholecystolithiasis complicated with CBDS,32 cases recurred,with an incidence of 28.07%.The risk factors for REC of patients with cholecystolithiasis combined with CBDS after operation were biliary tract infection,biliary mouth sphincterotomy,and operator experience≤3 years,biliary sphincter dysfunction(OR=4.170,4.047,3.568,3.367,P<0.05).Conclusion:The risk factors of REC in patients with cholecystolithiasis complicated with CBDS are biliary tract infection,biliary mouth sphincterotomy,experience of the operator≤3 years,and biliary sphincter dysfunction.Therefore,targeted intervention measures can be formulated to reduce the REC rate of patients with cholecystolithiasis complicated with CBDS after operation.
作者
贺利平
HE Li-ping(Department of Hepatobiliary,Pancreatic and Splenic Surgery,The Second Affiliated Hospital of Hengyang Medical College,Nanhua University,Hunan,Hengyang 421001)
出处
《实用中西医结合临床》
2022年第14期71-73,100,共4页
Practical Clinical Journal of Integrated Traditional Chinese and Western Medicine
关键词
胆囊结石
胆总管结石
复发
危险因素
Choledocholithiasis
Common bile duct stones
Recurrence
Risk factors
