胆总管取石并胆囊切除术后胆总管结石复发的相关危险因素分析  

Analysis of related risk factors for recurrence of choledocholithiasis after the operation

作　　者：鲁志华[1,2] 牛军[1] 许平平[3] 邱博[1,2] 孙祺[2] 姜远辉[2] 

机构地区：[1]山东大学齐鲁医院普外科,山东济南250012 [2]山东大学齐鲁医院(青岛)普外科,山东青岛266000 [3]复旦大学附属中山医院普外科,上海200032

出　　处：《中国现代普通外科进展》2016年第5期372-375,共4页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:探讨胆总管结石(CBDS)取石合并胆囊切除患者术后CBDS复发的危险因素。方法:回顾性分析2003年1月—2012年2月我院收治的333例CBDS取石并胆囊切除患者的病例资料,将可能影响CBDS术后复发的因素进行Logistic回归多因素分析,明确CBDS术后复发的相关危险因素。结果:333例患者中297例获得确切随访资料(失访率11%),31例患者CBDS复发,复发率10.4%。伴有壶腹周围憩室(PA D)、多发CBDS、胆总管直径≥15 mm与胆总管取石合并胆囊切除术后CBDS复发相关。结论:胆总管取石合并胆囊切除术后CBDS复发的危险因素为伴PA D,多发CBDS(结石数量≥2),胆总管直径≥15 mm。对于存在复发危险因素的患者,应进行积极干预,并在术后密切随访。Objective： The study was to evaluate the risk factors for recurrence of CBD stone patients who underwent cholecystectomy after the removal of CBD stone. Methods： We have a retrospective analysis about the clinical data of 333 cases ,who had common bile duct stones removal and cholecystectomy in our hospital during the period from January 2003 to February 2012, We have a univariate analysis of the factors,And the variable which was statistically significant through univariate analysis was involved in the non-conditional logistic regression analysis,and multivariate analysis was performed to determine the risk factors associated with recurrence of common bile duct stones. Results： Among the 333 patients ,a total of 297 patients were exactly followed up at last （dropout rate 11%）. 31 patients were with common bile duct stone recurrence, and the re- currence rate was 10.4%,After the Logistic regression multivariate analysis, Peri-ampullary diverticulum, multiple common bile duct stones, the common bile duct diameter≥15mm are the main recurrence risk factors of common bile duct stone in the patients under cholecystectomy associated with common bile duct stone extraction. Conclusion： The main recurrence risk factors of common bile duct stone in the patients under cholecystectomy associated with common bile duct stone extraction were： （1）with the peri-ampullary diverticulum; （2） multiple common bile duct stones （stone number≥2）; （3） the common bile duct diameter-〉 15mm. Clinicians ought to make a careful assessment of the risk of recurrence in the treatment of patients with common bile duct stones, and give an active intervention in the patients with the presence of the risk factors for recurrence, and a closely follow-up observation after surgery.

关 键 词：胆总管结石 复发 危险因素 

分 类 号：R575.62[医药卫生—消化系统]