腹腔镜外科杂志2024，Vol.29Issue(5)：347-352,6.DOI:10.13499/j.cnki.fqjwkzz.2024.05.347
老年胆总管结石患者行腹腔镜胆总管探查术围术期并发症的危险因素分析
Risk factors analysis of perioperative complications after laparoscopic common bile duct exploration for elderly patients with choledocholithiasis
摘要
Abstract
Objective:To analyze the perioperative complications and risk factors of laparoscopic common bile duct exploration(LCBDE)in the treatment of elderly patients with choledocholithiasis.Methods:A retrospective case-control study was used to collect the clinical data of 137 elderly patients with choledocholithiasis who underwent LCBDE from Jan.2021 to Jul.2023,and to observe the occurrence of perioperative complications using Clavien-Dindo grading.The risk factors of grade Ⅱ and above complications were ana-lyzed by univariate and multivariate logistic regression,and receiver operating characteristic curves were drawn.Results:Perioperative complications occurred in 63 patient(45.99%),Clavien-Dindo grading was grade Ⅰ 31.39%(43/137),grade Ⅱ 10.95%(15/147),Grade Ⅲa 2.92%(4/137),Grade Ⅲb 0.73%(1/137).The results of multivariate logistic regression analysis showed that the Charlson comorbidity index)≥4(OR=4.520,95%CI=1.141～17.912,P=0.032),American society of anesthesiologists physical status≥Ⅲ(OR=4.330,95%CI=1.014～18.496,P=0.048),and concomitant moderate to severe acute cholangitis(OR=9.531,95%CI=2.410～37.696,P=0.001)were independent risk factors for perioperative complications.The area under the curve of the three risk factors and the combined prediction probability was 0.766,0.761,0.748 and 0.864,respectively.Conclusions:Charlson comorbidity index≥4,American society of anesthesiologists physical status≥Ⅲ,and concomitant moderate to severe acute cholangitis are independent risk factors for perioperative complications after LCBDE in elderly patients with choledocholithiasis.Preoperative evalu-ation,recognition of these three risk factors,and early intervention should be fully valued.关键词
胆总管结石病/胆总管探查术/腹腔镜检查/老年人/围手术期并发症/危险因素Key words
Choledocholithiasis/Common bile duct exploration/Laparoscopy/Aged/Perioperative complications/Risk factors分类
医药卫生引用本文复制引用
鲁为朋,孙礼侠,徐庆春,刘志刚..老年胆总管结石患者行腹腔镜胆总管探查术围术期并发症的危险因素分析[J].腹腔镜外科杂志,2024,29(5):347-352,6.基金项目
安徽省"十四五"临床重点专科项目(皖卫教科发[2021]1号) （皖卫教科发[2021]1号）
芜湖市卫健委项目(WHWJ2021y021) （WHWJ2021y021）
华东师范大学附属芜湖医院临床科研项目(LC2022A04) （LC2022A04）
