Risk factors for bile leakage after laparoscopic common bile duct exploration in older patients with choledocholithiasis  

作　　者：Ruo-Fei Xiong Shan-Shan Lu Zhi-Ming Wu Hong-Jun Huang Tao Xiao 

机构地区：[1]Department of General Surgery,Shaoxing Central Hospital,Shaoxing 312000,Zhejiang Province,China [2]Department of Geriatrics,Shaoxing University Affiliated Hospital,Shaoxing 312000,Zhejiang Province,China [3]Department of General Surgery,First Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi Province,China

出　　处：《World Journal of Gastrointestinal Surgery》2025年第4期150-160,共11页世界胃肠外科杂志(英文)

基　　金：Supported by the Ke Qiao Science and Technology Plan Projects,No.2022KZ70.

摘　　要：BACKGROUND At present,there are few studies on the risk factors for bile leakage after laparoscopic common bile duct exploration(LCBDE)for older patients with choledocholithiasis.AIM To identify the potential risk factors for bile leakage after LCBDE in older patients.METHODS A retrospective,single-center observational analysis was performed on patients aged≥70 years with choledocholithiasis treated by LCBDE who were admitted to our center between January 2011 and August 2022.The included patients were divided into non-bile leakage and bile leakage groups.Risk factors were determined by analyzing the observation indicators.RESULTS Seventy older patients with choledocholithiasis who underwent LCBDE were included.Univariate analysis showed that positive culture of bile bacteria was a risk factor for bile leakage after LCBDE(P<0.05).We further analyzed the bile bacteria,and univariate analysis showed that Enterococcus faecalis(E.faecalis)(P<0.05)and Pseudomonas aeruginosa(P<0.05)were associated with an increased risk of postoperative bile leakage in older patients(P<0.05).Multivariate analysis showed that E. faecalis was an independent risk factor for postoperative bile leakage in older patients (P < 0.05). Theresults of antibiotic sensitivity analysis showed that E. faecalis had 100% susceptibility to penicillin, ampicillin,linezolid, vancomycin, and furantoin.CONCLUSIONE. faecalis-associated biliary tract infection is an independent risk factor for bile leakage after LCBDE in olderpatients with choledocholithiasis. We suggest coverage with antibiotics to which E. faecalis is sensitive.

关 键 词：Bile leakage Common bile duct stones Older patients Laparoscopic common bile duct exploration Enterococcus faecalis Antibiotic sensitivity 

分 类 号：R65[医药卫生—外科学]