摘要
目的探讨ERCP联合腹腔镜胆囊切除术（LC）治疗胆总管结石合并胆囊结石患者术后胆总管结石复发的相关危险因素。方法选取2008年至2012年新发胆总管结石合并胆囊结石患者行ERCP联合LC治疗并随访，胆总管结石复发与性别、年龄、体重指数、胆固醇水平、胆总管直径、胆总管结石的性质、数量及大小、乳头旁憩室、胆汁细菌培养结果等危险因素之间的关系采用logistic回归分析方法。结果共筛选出75例患者，随访时间为3-7年，结果胆总管结石复发19例，未复发56例。logistic回归分析显示，胆固醇〉5.72 mmol/L（OR＝5.21，95%CI：1.09-24.80，P＝0.038），胆总管扩张（OR＝3.22，95%CI：1.08-9.60，P＝0.036），合并乳头旁憩室（OR＝8.28，95%CI：1.05-65.35，P＝0.045）为ERCP联合LC术后胆总管结石复发的独立危险因素。结论高胆固醇血症、胆总管扩张、合并乳头旁憩室的胆总管结石合并胆囊结石患者，ERCP联合LC术后胆总管结石易复发。
Objective To explore the risk factors for the recurrence of common bile duct stones （CBDS） after the surgery of endoscopic retrograde cholangiopanereatography（ERCP） combined with laparo- scopic cholecystectomy（LC） for patients with both CBDS and gallbladder stones. Methods Data of patients diagnosed as having CBDS and gallbladder stones and treated by ERCP combined with LC between 2008 and 2012 were retrospectively analyzed. The relationship between CBDS recurrence and the possible risk factors such as gender, age, body mass index, level of cholesterol, bile duct diameter, composition, number and size of CBDS, periampullary diverticula and the result of bile bacteria culture were analyzed with logistic regression. Results A total of 75 patients were included and followed up for 3-7 years with CBDS recurrence in 19 patients and no recurrence in 56 others. Logistic regression analysis showed that cholesterol higher than 5.72 mmol/L （OR= 5.21, 95%CI： 1.09-24. 80, P= 0. 038） , common bile duct expansion （ OR = 3.22, 95 % CI： 1.08-9.60, P = 0. 036）, periampullary diverticula （ OR = 8. 28, 95% CI： 1.05-65.35, P = 0.045） were risk factors for recurrence of CBDS. Conclusion Hypercholesterolemia, common bile duct expansion and periampullary diverticula are risk factors for recurrence of CBDS after ERCP combined with LC.
出处
《中华消化内镜杂志》
北大核心
2016年第10期689-692,共4页
Chinese Journal of Digestive Endoscopy
关键词
胆总管结石
复发
危险因素
Calculus of common bile duct
Recurrence
Risk factors
