肝胆胰外科杂志2025，Vol.37Issue(4)：243-249,7.DOI:10.11952/j.issn.1007-1954.2025.04.005
先天性胆管扩张症儿童与成人根治术后的远期预后对比分析
A long-term comparative prognosis analysis of pediatric and adults patients with congenital biliary dilatation after radical surgery
摘要
Abstract
Objective To investigate the differences of long-term prognosis and disease progression between pediatric and adult patients with congenital biliary dilatation(CBD)after radical surgery.Methods The clinical data of 146 pediatric CBD patients(age≤14 years at the time of radical surgery,the children group)and 123 adult CBD patients(age>14 years at the time of radical surgery,the adult group),who admitted to the Affiliated Hospital of Qingdao University between Jun.2013 and Jun.2023,were retrospectively analyzed.The basic data,CBD classification,surgical data and postoperative complications were compared between the two groups.Both groups were followed-up to observe the postoperative complication incidences,especially focusing on the incidence in children as they transitioned to adulthood.Logistic regression analysis was used to explore the risk factors affecting the postoperative complications of CBD patients after radical surgery.Results All 146 patients in the children group were followed-up for 0.6 to 144.1 months,and 123 patients in the adult group were followed-up for 1.0 to 743.4 months.The re-hospitalization rate[25.20%(31/123)vs 15.07%(22/146),χ2=4.334,P=0.003],biliary stone incidence rate[41.46%(51/123)vs 6.16%(9/146),χ2=48.000,P<0.001],and biliary malignant transformation rate[10.57%(10/123)vs 1.37%(2/146),χ2=10.730,P=0.001]in the adult group were significantly higher than those in the child group.The incidence rate of postoperative new stones incidence rate in the adult group was higher than that in the child group[54.90%(28/51)vs 44.44%(4/9),χ2=0.756,P=0.385],but the difference was not statistically significant(P>0.05);and the median time from undergoing the first radical surgery to the onset of new stones in the adult group was shorter than that in the child group[3.5(0.5,48.0)months vs 72.0(60.0,120.0)months,Z=0.157,P<0.001].Logistic regression analysis showed that,the age of undergoing radical surgery(OR=0.970,95%CI 0.958 to 0.982,P<0.001)and the age of the first CBD onset(OR=0.972,95%CI 0.960 to 0.984,P<0.001)were independent risk factors for the postoperative complications of CBD patients.Conclusion The incidence of postoperative complications such as biliary stone in the adult CBD patients is significantly higher than that in the child CBD patients.Patients with CBD should be received radical surgery as soon as possible and the long-term followed-up is necessary.关键词
先天性胆管扩张症/根治性手术/成人患者/儿童患者/远期预后/术后结石并发症Key words
congenital biliary dilatation/radical surgery/adult patients/children patients/long-term prognosis/postoperative biliary stones complications分类
临床医学引用本文复制引用
张天一,郝希伟,于仑,董蒨,修文丽,李美娇,王静淼,张警丽,夏楠,朱呈瞻,段于河,周显军..先天性胆管扩张症儿童与成人根治术后的远期预后对比分析[J].肝胆胰外科杂志,2025,37(4):243-249,7.基金项目
青岛市关键技术攻关及产业化示范类项目(24-1-4-xxgg-16-nsh). （24-1-4-xxgg-16-nsh）
