四川医学2024，Vol.45Issue(5)：497-501,5.DOI:10.16252/j.cnki.issn1004-0501-2024.05.008
腹腔镜下胆总管切开取石一期缝合术后胆漏相关危险因素分析
Analysis of Risk Factors Related to Bile Leakage after Laparoscopic Common Bile Duct Incision and Lithotomy and One-Stage Suture
陈广 1黄川 1丁兵 2凌俊 2张勇 2蒋辉1
作者信息
- 1. 西南医科大学附属医院肝胆外科,四川 泸州 646000||内江市第二人民医院肝胆外科,四川 内江 641000
- 2. 内江市第二人民医院肝胆外科,四川 内江 641000
- 折叠
摘要
Abstract
Objective To investigate the independent risk factors of bile leakage after laparoscopic bile duct stone extrac-tion with one-stage suturing and to develop prevention strategies to improve the clinical practice of laparoscopic bile duct stone extrac-tion with one-stage suturing and reduce the incidence of postoperative bile leakage.Methods The clinical data of 102 patients ad-mitted to our hospital from 2019 to 2023 with common bile duct stones and laparoscopic biliary resection with one-stage suture were retrospectively analyzed,and the patients were divided into bile leak group(n=18)and non-bile leak group(n=84)according to whether they had bile leakage after surgery.The general data,serum albumin,number of stones,diameter of common bile duct,op-eration time,intraoperative bleeding,suturing method,and surgical experience of the attending surgeon were analyzed in all pa-tients.Risk factors for postoperative biliary leakage were explored by univariate analysis and multifactorial Logistic regression analy-sis,and risk factor indicators were included in the subject work characteristics(ROC)curve for analysis.Results Among the 102 patients,18 patients developed bile leakage,induding 16 grade A bile leaks and 2 grade B bile leaks.The results of univariate and multivariate Logistic regression analysis of the clinical data of the two groups showed that:operator experience<30 cases,low preop-erative serum albumin,and the use of continuous suture bile duct closure were independent risk factors for postoperative bile leak,and the differences were statistically significant(all P<0.05).The results of the subject work characteristic(ROC)curve analysis:the cut-off value of preoperative albumin level was 37.45 g/L(P<0.05).Conclusion Preoperative serum albumin lower than 37.45 g/L,continuous sutured common bile duct incision,and operator surgical experience<30 cases can be used as a significant theoretical basis for predicting bile leakage after laparoscopic common bile duct dissection and lithotomy with one-stage suturing.关键词
胆总管结石/腹腔镜下胆道切开取石一期缝合术/胆漏/危险因素Key words
common bile duct/laparoscopic common bile duct dissection and lithotomy with one-stage suturing/bile leakage/risk factors分类
医药卫生引用本文复制引用
陈广,黄川,丁兵,凌俊,张勇,蒋辉..腹腔镜下胆总管切开取石一期缝合术后胆漏相关危险因素分析[J].四川医学,2024,45(5):497-501,5.
