详细信息
胆囊结石合并胆总管结石术后复发的危险因素分析 被引量:49
Analysis of risk factors for postoperative recurrence of gallbladder stones with common bile duct stones
文献类型:期刊文献
中文题名:胆囊结石合并胆总管结石术后复发的危险因素分析
英文题名:Analysis of risk factors for postoperative recurrence of gallbladder stones with common bile duct stones
作者:裘文刚[1];徐江[2]
机构:[1]浙江省绍兴县中医院普通外科;[2]绍兴文理学院附属医院普通外科
年份:2014
卷号:23
期号:2
起止页码:170
中文期刊名:中国普通外科杂志
外文期刊名:Chinese Journal of General Surgery
收录:CSTPCD、、北大核心2011、CSCD_E2013_2014、北大核心、CSCD
语种:中文
中文关键词:胆囊结石病;胆总管结石;复发;危险因素
外文关键词:Cholecystolithiasis; Choledocholithiasis; Recurrence; Risk Factors
中文摘要:目的:探讨内镜手术治疗胆囊结石合并胆总管结石患者复发的相关影响因素。方法:回顾性分析2010年1月—2012年12月应用内镜治疗胆囊结石合并胆总管结石99例患者(51例行腹腔镜下胆囊切除+胆总管切开取石术,48例行腹腔镜下胆囊切除+十二指肠镜乳头切开取石术)的临床与随访资料,对影响结石复发的相关因素行单因素与多因素分析。结果:术后共19例患者复发,复发率为19.19%。单因素分析显示,术后结石复发与年龄、黄疸、胆管扩张、胆总管直径、结石最大直径、结石数目、胆管、胰腺炎症以及手术类型等因素有关(均P<0.05),Logistic多因素回归分析发现,年龄(O R=2.692,P=0.011)、胆总管直径(O R=2.249,P=0.022)、结石数量(O R=2.647,P=0.017)、结石最大直径(O R=2.348,P=0.009)、合并炎症(OR=2.801,P=0.013)、手术类型(OR=2.421,P=0.018)是结石复发的独立危险因素。结论:内镜手术治疗胆囊结石合并胆总管结石术后结石复发受多种因素影响,应当根据具体情况采用有针对性措施降低复发率。
外文摘要:Objective: To analyze the factors affecting stone recurrence in patients with gallbladder stones and concomitant common bile duct stones after endoscopic treatment. Methods: The clinical and foUow-up data of 99 patients with gallbladder stones and concomitant common bile duct stones undergoing endoscopic treatment(51 cases undergoing laparoscopic cholecystectomy plus common bile duct exploration and 48 cases undergoing laparoscopic cholecystectomy plus endoscopic sphincterotomy) from January 2010 to December 2012 were retrospectively analyzed. The related factors affecting stone recurrencewere determined by univariate and multivariate analysis. Results: Stone recurrence occurred in 19 patients after operation, and the recurrence rate was 19.19%. Univariate analysis showed that postoperative stone recurrence was significantly associated with the factors that included age, jaundice, bile duct dilation, common bile duct diameter, stone maximum diameter and number, inflammation of the pancreas and procedure type(all P〈0.05). Logistic regression analysis identified that age (0R=2.692, P=0.011), common bile duct diameter (OR=2.249, P=0.022), stone number(OR=2.647, P=0.017), maximum diameter of the stone (0R=2.348, P=0.009), combined inflammation (0R=2.801, P=0.013) and procedure type (OR=2.421, P=0.018) were the independent risk factors for stone recurrence. Conclusion: Postoperative stone recurrence in patients with gallbladder stones and concomitant common bile duct stones undergoing endoscopic treatment is affected by many factors, so the relevant measures should be tailored to specific conditions to reduce stone recurrence.
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