中国普通外科杂志2025，Vol.34Issue(1)：79-87,9.DOI:10.7659/j.issn.1005-6947.240501
肝胆管结石病患者肝切除术前体质量指数与术后严重并发症的关系
Relationship between preoperative body mass index and severe postoperative complications in patients with hepatolithiasis undergoing liver resection
摘要
Abstract
Background and Aims:Body mass index(BMI),an important indicator of nutrition and health,is closely associated with postoperative complications.This study was performed to investigate the relationship between preoperative BMI and severe complications in patients undergoing liver resection for hepatolithiasis,aiming to provide preoperative guidance for clinicians,reduce the risk of postoperative complications,and ensure surgical safety and efficacy. Methods:The clinical data of 484 patients with hepatolithiasis who underwent liver resection between May 2006 and December 2022 at the First Affiliated Hospital of Army Medical University and Beijing Tsinghua Changgung Hospital were retrospectively collected.Patients were classified into low BMI group(≤18.4 kg/m2),normal BMI group(18.5-24.9 kg/m2),and high BMI group(≥25.0 kg/m2)based on preoperative BMI.Baseline characteristics,overall complications,severe complications,and other postoperative outcomes were compared between the normal BMI group and the low group as well as the high BMI group.Risk factors for severe complications after liver resection were analyzed. Results:Among the 484 patients,79(16.3％)were in the low BMI group,328(67.8％)in the normal BMI group,and 77(15.9％)in the high BMI group.The high BMI group had significantly higher ASA score,preoperative albumin level,and proportion of hypertension compared to the normal BMI group(all P＜0.05).Baseline characteristics in the low BMI group showed no significant differences compared to the normal BMI group(all P＞0.05).The incidence rates of overall complications were not significantly among the three groups(P＞0.05).However,the high BMI group had significantly higher incidence rates of severe complications(Clavien-Dindo grade Ⅲ-Ⅳ),postoperative infections,liver failure,and bile leakage compared to the normal BMI group;the low BMI group had significantly higher rates of perioperative blood transfusion,postoperative infections,liver failure,and reoperation compared to the normal BMI group(all P＜0.05).Univariate and multivariate Logistic regression analyses identified high BMI and preoperative total bilirubin ≥54 pmol/L as independent risk factors for severe complications after liver resection in patients with hepatolithiasis(both P＜0.05). Conclusion:Preoperative BMI is closely associated with the occurrence of complications after liver resection in patients with hepatolithiasis,with high BMI being an independent risk factor for severe complications.To mitigate the risk of severe complications,clinical practice should prioritize monitoring and management of individuals with high BMI and other risk factors关键词
肝切除术/手术后并发症/胆石症/人体质量指数/危险因素Key words
Hepatectomy/Postoperative Complications/Cholelithiasis/Body Mass Index/Risk Factors分类
医药卫生引用本文复制引用
简睿,金烁,陈志宇,李晨曦,刘智鹏,杨雪儿,罗宇乐,白洁,江艳,弓毅,戴海粟..肝胆管结石病患者肝切除术前体质量指数与术后严重并发症的关系[J].中国普通外科杂志,2025,34(1):79-87,9.基金项目
西南医院临床研究孵化基金资助项目(23IITZD06). （23IITZD06）
