急性胆囊炎伴胆囊结石患者LC术后胆管损伤的影响因素分析  

Analysis on the Influential Factors of Bile Duct Injury After LC in Patients with Acute Cholecystitis Complicated with Cholecystolithiasis

作　　者：尤长征 冯运祥 刘高升 YOU Changzheng;FENG Yunxiang;LIU Gaosheng(Department of General Surgery,the People's Hospital of Queshan County,Zhumadian 463000,China)

机构地区：[1]河南省确山县人民医院普外科,河南驻马店463000

出　　处：《临床医学工程》2021年第8期1135-1136,共2页Clinical Medicine & Engineering

基　　金：2019年河南省医学科技攻关计划联合共建项目(项目编号:LHGJ20190158)。

摘　　要：目的探讨急性胆囊炎伴胆囊结石患者腹腔镜胆囊切除术(LC)术后胆管损伤的影响因素。方法回顾性分析2016年3月至2020年2月于我院接受LC治疗的4560例急性胆囊炎伴胆囊结石患者的临床资料,分析术后胆管损伤的影响因素。结果4560例患者中有21例发生术后胆管损伤,发生率为0.46%。经单因素及Logistic回归分析显示,胆囊壁增厚、胆囊三角解剖变异、术中粘连、胆管长度较短、胆管异常解剖为急性胆囊炎伴胆囊结石患者LC术后胆管损伤发生的危险因素(P<0.05)。结论胆囊壁增厚、胆囊三角解剖变异、术中粘连、胆管长度较短、胆管异常解剖是急性胆囊炎伴胆囊结石患者LC术后胆管损伤发生的危险因素,临床应重点关注上述危险因素并采取针对性措施,以减少术后胆管损伤的发生。Objective To explore the influential factors of bile duct injury after laparoscopic cholecystectomy(LC)in patients with acute cholecystitis complicated with cholecystolithiasis.Methods The clinical data of 4560 patients with acute cholecystitis complicated with cholecystolithiasis who were treated with LC in our hospital from March 2016 to February 2020 were analyzed retrospectively.The influential factors of postoperative bile duct injury were analyzed.Results Among 4560 patients,postoperative bile duct injury occurred in 21 cases(0.46%).Single factor analysis and Logistic regression analysis showed that thickening of gallbladder wall,anatomic variation of gallbladder triangle,intraoperative adhesion,short length of bile duct,anatomic abnormality of bile duct were the risk factors for occurrence of bile duct injury after LC(P<0.05).Conclusions Thickening of gallbladder wall,anatomic variation of gallbladder triangle,intraoperative adhesion,short length of bile duct,anatomic abnormality of bile duct are risk factors for occurrence of bile duct injury after LC.Clinical attention should be paid to the above risk factors and targeted measures should be taken to reduce the occurrence of postoperative bile duct injury.

关 键 词：急性胆囊炎 胆囊结石 腹腔镜胆囊切除术 胆管损伤 

分 类 号：R619[医药卫生—外科学]