LCBDE及一期缝合术后发生胆瘘及胆总管狭窄的影响因素分析  

Analysis of Risk Factors for Bile Leak and Common Bile Duct Stricture After LCBDE and Primary Closure

作　　者：阮井勇 RUAN Jingyong(DepartmentⅠof Surgery,The Second Hospital of Zhangzhou,Zhangzhou 363100,China)

机构地区：[1]漳州市第二医院外一科,漳州363100

出　　处：《中国医药指南》2024年第32期83-86,共4页Guide of China Medicine

摘　　要：目的研究腹腔镜胆总管探查(LCBDE)及一期缝合术(PDC)后发生胆瘘及胆总管狭窄的影响因素。方法回顾性分析2021年2月至2024年2月于漳州市第二医院接受LCBDE及PDC治疗的82例患者的临床资料。采用单因素分析及多因素Logistic回归分析明确LCBDE及PDC后胆瘘及胆总管狭窄的危险因素。结果单因素分析发现,糖尿病、胆总管直径、手术时长及胆总管缝合方式与LCBDE及PDC后发生胆瘘和胆总管狭窄有关(均P<0.05)。多因素Logistic回归分析显示,糖尿病、胆总管直径<1 cm、手术时长≥120 min和胆总管连续缝合是LCBDE及PDC后胆瘘发生的危险因素(OR=2.385、6.106、5.409、4.130,P<0.05);糖尿病、胆总管直径<1 cm、手术时长≥120 min和胆总管连续缝合是LCBDE及PDC后胆总管狭窄的危险因素(OR=2.301、4.159、3.201、2.791,P<0.05)。结论糖尿病、胆总管直径<1 cm、手术时长≥120 min和胆总管连续缝合是LCBDE及PDC后胆瘘和胆总管狭窄的危险因素。临床工作中可针对上述危险因素开展干预,从而达到降低胆瘘及胆总管狭窄发生风险的目的。Objective To investigate the risk factors for bile leak and common bile duct(CBD)stricture after laparoscopic common bile duct exploration(LCBDE)and primary duct closure(PDC).Methods A retrospective analysis was conducted on the clinical data of 82 patients who underwent LCBDE and PDC treatment at Zhangzhou City Second Hospital from February 2021 to February 2024.Univariate analysis and multivariate Logistic regression analysis were used to identify the risk factors for bile leak and CBD stricture after LCBDE and PDC.Results Univariate analysis found that diabetes,common bile duct diameter,surgical duration,and the method of bile duct suture were associated with the occurrence of bile leak and CBD stricture after LCBDE and PDC(all P<0.05).Multivariate Logistic regression analysis showed that diabetes,common bile duct diameter<1 cm,surgical duration≥120 min,and continuous bile duct suture were risk factors for bile leak after LCBDE and PDC(OR=2.385,6.106,5.409,4.130,P<0.05);diabetes,common bile duct diameter<1 cm,surgical duration≥120 min,and continuous bile duct suture were risk factors for CBD stricture after LCBDE and PDC(OR=2.301,4.159,3.201,2.791,P<0.05).Conclusions Diabetes,common bile duct diameter<1 cm,surgical duration≥120 min,and continuous bile duct suture are risk factors for bile leak and CBD stricture after LCBDE and PDC.Clinical interventions targeting these risk factors can be implemented to reduce the risk of bile leak and CBD stricture.

关 键 词：腹腔镜 胆总管探查术 一期缝合术 胆瘘 胆总管狭窄 危险因素 

分 类 号：R657.4[医药卫生—外科学]