胆管空肠吻合术后肝胆管结石复发的危险因素  

The Risk Factor Analysis for Recurrence in the Treatment of Choledochojejunostomy for Hepatolithiasis

作　　者：张明雄 张小文[2] ZHANG Ming-xiong;ZHANG Xiao-wen(Dept.of Anesthesia Surgery,Yunnan Cancer Hospital,Yunnan Cancer Center,Kunming Yunnan 650118;The Second Ward of Hepatobiliary Pancreatic Surgery,the Second Affiliated Hospital of Kunming Medical University,Clinical Medicine Center for Hepatobiliary and Pancreatic Diseases of Yunnan Province,Kunming Yunnan 650032,China)

机构地区：[1]云南省肿瘤医院/云南省癌症中心麻醉手术科,云南昆明650118 [2]昆明医科大学第二附属医院肝胆胰外科二病区/云南省肝胆胰疾病临床医学中心,云南昆明650032

出　　处：《昆明医科大学学报》2021年第9期76-82,共7页Journal of Kunming Medical University

基　　金：国家自然科学基金资助项目(81760430)。

摘　　要：目的探讨肝胆管结石患者采用胆管空肠术治疗后结石复发的危险因素。方法回顾性分析昆明医科大学第二附属医院2014年6月至2019年6月行胆管空肠吻合手术的肝胆管结石患者的临床资料。按照胆管结石复发标准将纳入患者分为复发组和非复发组,通过单因素和多因素分析确定肝胆管结石复发的相关危险因素。结果最终共纳入77例行胆管空肠吻合术的肝胆管结石患者,所有患者均随访成功,其中复发组21例,未复发组56例。单因素分析及多因素分析均显示:结石大小≥10 mm、胆总管直径<20 mm、多处结石、胆道炎症、吻合器吻合、无支撑管、无胆道引流、未行肝切除是胆管空肠吻合术后肝胆管结石复发的危险因素(P<0.05)。结论结石≥10 mm、胆总管直径<20 mm、多处结石、胆道炎症、吻合器吻合、无支撑管、无胆道引流、未行肝切除是胆管空肠吻合术后肝胆管结石复发的危险因素。Objective To study the related risk factor of recurrence after the treatment of choledochojejunostomy in hepatolithiasis.Methods Retrospective analysis was performed on the clinical data of patients with hepatolithiasis who underwent biliary jejunostomy in the Second Affiliated Hospital of Kunming Medical University from June 2014 to June 2019.According to the criteria for recurrence of bile duct stones,the included patients were divided into the recurrence group and the non-recurrence group.Results A total of 77 patients with hepatolithiasis and undergoing the underwent choledochojejunostomy were included in this study,all of whom were followed up successfully,including 21 in the recurrence group and 56 in the non-recurrence group.Univariate analysis and multivariate analysis showed that stone size≥10 mm,choledochal diameter<20 mm,stone location,biliary inflammation,anastomotic anastomosis,no supporting tube,no biliary drainage and no hepatectomy were the risk factors for recurrence of hepatolithiasis after the biliary jejunectomy(P<0.05).Conclusion Stone size≥10 mm,choledochal diameter<20 mm,stone location,biliary inflammation,anastomotic anastomosis,no supporting tube,no biliary drainage and no hepatectomy are the risk factors for the recurrence of hepatolithiasis after the biliary jejunectomy.

关 键 词：胆管空肠吻合术 肝胆管结石 复发 危险因素 

分 类 号：R575.623[医药卫生—消化系统]