腹腔镜外科杂志2025，Vol.30Issue(11)：809-813,830,6.DOI:10.13499/j.cnki.fqjwkzz.2025.11.809
腹腔镜联合胆道镜胆总管切开取石一期缝合术后胆漏的危险因素分析
Risk factors analysis for bile leakage after laparoscopic combined with choledochoscopic choledocholithotomy with primary closure
摘要
Abstract
Objective:To explore the risk factors for postoperative bile leakage in patients undergoing laparoscopic combined choledochoscopic choledocholithotomy with primary closure.Methods:A retrospective analysis was conducted on the preoperative exa-mination results and clinical data of 315 patients who underwent choledocholithotomy using 3D laparoscopy combined with choledochos-copy followed by primary closure between Jan.2019 and Mar.2023.Patients were divided into a bile leakage group and a non-bile leak-age group.Univariate and multivariate logistic regression analyses were employed to identify the risk factors for postoperative bile leak-age,which were subsequently evaluated using receiver operating characteristic curve analysis.Results:Postoperative bile leakage occurred in19 cases,with an incidence rate of 6.03%.Univariate analysis revealed statistically significant differences between the two groups in terms of diabetes mellitus(P=0.009),preoperative serum albumin(P=0.005),and common bile duct diameter(P=0.016).Multivariate logistic regression analysis demonstrated that low preoperative serum albumin and small common bile duct diame-ter were independent risk factors for postoperative bile leakage(P<0.05).Receiver operating characteristic curve analysis showed that preoperative serum albumin and common bile duct diameter had predictive value for bile leakage,with optimal cutoff values of 32.25 g/L and 8.5 mm,respectively.Conclusions:Low preoperative serum albumin(<32.25 g/L)and a smaller common bile duct diameter(<8.5 mm)are independent risk factors for bile leakage after laparoscopic combined with choledochoscopic choledocholithotomy with pri-mary closure.Surgeons can use these indicators for individualized decision-making to reduce the risk of postoperative bile leakage.关键词
胆总管结石病/腹腔镜检查/胆道镜检查/胆总管切开取石术/一期缝合/胆漏/危险因素Key words
Choledocholithiasis/Laparoscopy/Choledochoscopy/Choledocholithotomy/Primary closure/Bile leakage/Risk fac-tors分类
医药卫生引用本文复制引用
蒋敬平,余强锋,吴淑宁,李根丛,李伟,张卓凡,宋益鹏..腹腔镜联合胆道镜胆总管切开取石一期缝合术后胆漏的危险因素分析[J].腹腔镜外科杂志,2025,30(11):809-813,830,6.基金项目
珠海市医学科研项目(2220009000278) （2220009000278）
深圳市南山区技术研发和创意设计项目(NS2024072) （NS2024072）
