腹腔镜胰腺中段切除术后并发胆囊结石的危险因素分析  

Risk factors analysis of cholecystolithiasis after laparoscopic central pancreatectomy

作　　者：袁天 熊光冰 冀旭 乔梁[1] 汪小祥 朱峰[1] YUAN Tian;XIONG Guangbing;JI Xu(Department of Biliary-Pancreatic Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院胆胰外科,湖北武汉430030

出　　处：《腹腔镜外科杂志》2024年第3期184-188,共5页Journal of Laparoscopic Surgery

基　　金：国家自然科学基金青年科学基金项目(81902499);国家自然科学基金面上项目(81874205);2023年同济医院科研基金重点项目(2023A18)。

摘　　要：目的:探讨腹腔镜胰腺中段切除术后发生胆囊结石的影响因素。方法:回顾分析2021年6月至2023年8月为58例患者行腹腔镜胰腺中段切除术(LCP)的临床资料及随访资料,根据术后是否并发胆囊结石分为并发组与未并发组,分析LCP术后发生胆囊结石的影响因素。结果:58例患者中17例术后发生胆囊结石,发生率为29.3%。统计分析显示,两组患者术后体重下降过多(≥5%)、胰瘘(B级/C级)、胃排空延迟、BMI、奥曲肽用量差异有统计学意义(P<0.05);多因素Logistic回归分析显示,术后体重下降过多(OR=7.156,P<0.05)、胰瘘(OR=8.494,P<0.05)、BMI(OR=1.391,P<0.05)为LCP术后并发胆囊结石的独立危险因素。结论:术后体重下降过多、胰瘘、BMI是LCP术后并发胆囊结石的独立危险因素,可增加LCP术后并发胆囊结石的风险。围手术期治疗中应加强危险因素的识别与评估,根据患者病情予以临床干预,以减少LCP术后胆道并发症的发生。Objective:To investigate the influencing factors of cholecystolithiasis after laparoscopic central pancreatectomy.Methods:The clinical data and follow-up data of 58 patients who underwent laparoscopic central pancreatectomy(LCP)from Jun.2021 to Aug.2023 were retrospectively analyzed.The patients were divided into two groups according to whether they had cholecystolithiasis after surgery,and the influencing factors of concurrent cholecystolithiasis in LCP patients were analyzed.Results:In 58 LCP patients,postoperative gallstones occurred in 17 patients,with a complication rate of 29.3%.Statistical analysis showed that postoperative weight loss(≥5%),pancreatic fistula(grade B/C),delayed gastric emptying,BMI and octreotide dosage were statistically significantly different between the two groups(P<0.05).Multivariate logistic regression analysis showed that postoperative excessive weight loss(OR=7.156,P<0.05),pancreatic fistula(OR=8.494,P<0.05),BMI(OR=1.391,P<0.05)were independent risk factors for gallstone after LCP.Conclusions:Postoperative excessive weight loss,pancreatic fistula and BMI are independent risk factors for postoperative cholecystolithiasis after LCP,and can increase the risk of postoperative gallstones in LCP patients.In perioperative treatment,the identification and evaluation of risk factors should be strengthened,and clinical intervention should be carried out according to the patients'condition to reduce the occurrence of biliary tract complications after LCP.

关 键 词：胰腺中段切除术 腹腔镜检查 术后并发症 胆囊结石病 危险因素 

分 类 号：R657.5[医药卫生—外科学]