经腹腔镜逆行胆囊切除术治疗复杂胆囊结石患者的并发症相关因素分析  

Analysis of related factors of complications of laparoscopic retrograde cholecystectomy in patients with complex cholecystolithiasis

作　　者：罗军[1] 彭积院 潘铃娟[1] LUO Jun;PENG Jiyuan;PAN Lingjuan(Department of General Surgery,Fengcheng People's Hospital,Fengcheng,Jiangxi,331100,China)

机构地区：[1]丰城市人民医院普外科,江西丰城331100

出　　处：《当代医学》2024年第16期132-136,共5页Contemporary Medicine

摘　　要：目的分析经腹腔镜逆行胆囊切除术(laparoscopic retrograde cholecystectomy,LRC)治疗复杂胆囊结石(complicated gallbladder stones,CGS)出现并发症的相关因素。方法选取2020年1月至2022年8月于丰城市人民医院行LRC的66例CGS患者作为研究对象,入院后所有患者均行LRC治疗,并观察并发症发生情况。采用单因素分析、多因素Logisitic回归分析探讨患者术后发生并发症的影响因素。结果66例患者中,发生并发症9例(13.64%)。单因素分析结果显示,有并发症患者和无并发症患者的胆囊壁厚度、胆囊颈部结石、周围脏器粘连、Calot三角粘连情况、手术性质比较差异有统计学意义(P<0.05)。多因素Logisitic回归分析显示,胆囊壁厚度>5mm、胆囊颈部结石、周围脏器粘连、Calot三角粘连、急诊手术为患者术后发生并发症的独立危险因素(P<0.05)。结论胆囊壁厚度>5mm、胆囊颈部结石、周围脏器粘连、Calot三角粘连、急诊手术可增加CGS患者行LRC术后并发症的发生风险,早期识别和评估危险因素有助于其早期诊断和治疗,降低其术后并发症风险,改善预后。Objective To analyze the related factors of complications during laparoscopic retrograde cholecystectomy(LRC)for complicated gallstones(CGS).Methods 66 patients with CGS who underwent LRC in Fengcheng People's Hospital from January 2020 to August 2022 were se-lected as the study subjects,all patients were treated with LRC after admission,and the occurrence of complications was observed.Univariate analy-sis and multivariate Logisitic regression analysis were used to investigate the influencing factors of postoperative complications.Results Among the 66 patients,9(13.64%)had complications.The results of single factor analysis showed that there were statistically significant differences in gallblad-der wall thickness,gallbladder neck stones,adhesion of surrounding organs,Calot triangle adhesion and surgical nature between patients with compli-cations and those without complications(P<0.05).Multivariate Logisitic regression analysis showed that gallbladder wall thickness>5 mm,gall-bladder neck stone,peripheral organ adhesion,Calot triangle adhesion and emergency surgery were independent risk factors for postoperative compli-cations(P<0.05).Conclusion Gallbladder wall thickness>5 mm,gallbladder neck stones,surrounding organs adhesions,Calot triangle adhesions,and emergency surgery can increase the risk of postoperative complications in CGS patients after LRC.Early identification and assessment of risk factors can help early diagnosis and treatment,reduce the risk of postoperative complications,and improve prognosis.

关 键 词：复杂胆囊结石 经腹腔镜逆行胆囊切除术 并发症 

分 类 号：R657.4[医药卫生—外科学]