肝内胆管细胞癌腹腔镜根治性切除术后并发症危险因素分析  

Analysis of the risk factors of complications after laparoscopic radical resection of intrahepatic cholangiocarcinoma

作　　者：孟凡迪[1] 徐勤鸿 杨刚华 万永[1] 张雷[1] 王林[1] Meng Fandi;Xu Qinhong;Yang Ganghua;Wan Yong;Zhang Lei;Wang Lin(Department of Geriatric Surgery,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)

机构地区：[1]西安交通大学第一附属医院老年外科,西安710061

出　　处：《中国医学前沿杂志（电子版）》2020年第7期80-83,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：陕西省社会发展科技攻关项目(2015SF107)。

摘　　要：目的分析肝内胆管细胞癌(intrahepatic cholangiocarcinoma,ICC)腹腔镜根治性切除术后并发症的危险因素。方法回顾性分析2015年6月至2019年6月西安交通大学第一附属医院收治的153例ICC患者的临床资料。所有患者均行腹腔镜根治性切除术治疗,按照术后并发症发生情况,将其分别纳入并发症组和无并发症组,记录患者并发症Clavien-Dindo分级并比较两组患者临床资料,采用多因素Logistic回归分析探讨ICC腹腔镜根治性切除术后并发症的危险因素。结果153例ICC患者腹腔镜根治性切除术后共33例发生并发症,发生率为21.57%;并发症以Ⅰ级、Ⅱ级为主,分别占42.42%、27.27%。多因素Logistic回归分析结果显示,年龄≥65岁、美国麻醉师学会(American Society of Anesthesiologists,ASA)分级Ⅲ级、中重度肝硬化、术中肝门阻断和中转开腹均为ICC腹腔镜根治性切除术后并发症的独立危险因素(均P<0.05)。结论ICC腹腔镜根治性切除术后并发症发生率较高,影响因素包括年龄、ASA分级、术中肝门阻断、肝硬化程度、中转开腹等,应加强围术期管理、强调脏器功能保护,积极防治并发症的发生。Objective To analyze the risk factors of complications after laparoscopic radical resection of intrahepatic cholangiocarcinoma(ICC).Method The clinical data of 153 ICC patients admitted to the First Affiliated Hospital of Xi'an Jiaotong University from June 2015 to June 2019 were analyzed retrospectively.According to the occurrence of postoperative complications,patients were included in complication group and non-complication group respectively.The Clavien-Dindo classification of complications was recorded and the clinical data of the two groups were compared.Multivariate Logistic regression analysis was used to explore the risk factors of complications after laparoscopic radical resection of ICC.Result There were 33 complications in 153 patients with ICC after laparoscopic radical resection,the incidence was 21.57%;the main complications were gradeⅠand gradeⅡ,accounted for 42.42%and 27.27%respectively.Multivariate Logistic regression analysis showed that age≥65 years old,American Society of Anesthesiologists(ASA)gradeⅢ,moderate to severe cirrhosis,hepatic portal occlusion and conversion to laparotomy were indep endent risk factors of complications after laparoscopic radical resection of ICC(all P<0.05).Conclusion The incidence of com p lications after laparoscopic radical resection of ICC is high.The influencing factors include age,ASA classification,hepatic portal occlusion,degree of cirrhosis,conversion to laparotomy,etc.We should strengthen perioperative management and emph asize organ function protection to prevent and treat complications.

关 键 词：肝内胆管细胞癌 腹腔镜 根治性切除术 并发症 危险因素 

分 类 号：R735.7[医药卫生—肿瘤]