中国普通外科杂志2026，Vol.35Issue(2)：298-305,8.DOI:10.7659/j.issn.1005-6947.250612
腹腔镜胆囊切除术后胆汁漏的危险因素分析及预测模型构建
Risk factors for bile leakage after laparoscopic cholecystectomy and construction of a predictive model
王松 1李权 1刘建 1朱征全 1刘甫1
作者信息
- 1. 河南省南阳市第一人民医院 肝胆胰脾外科,河南 南阳 473000
- 折叠
摘要
Abstract
Background and Aims:Bile leakage is a common and clinically significant complication after laparoscopic cholecystectomy(LC),which may delay recovery and increase the need for reintervention.This study aimed to identify risk factors for bile leakage after LC and to develop a predictive regression model.
Methods:A retrospective analysis was conducted on 1 630 patients who underwent LC between September 2020 and May 2025.Univariate and multivariate logistic regression analyses were performed to identify independent risk factors,and a predictive model was established.The performance of the model was evaluated using receiver operating characteristic(ROC)analysis.
Results:Bile leakage occurred in 81 patients(4.97%).Multivariate analysis identified common bile duct diameter≤3 mm,gallbladder neck stones,anatomical variation,Calot's triangle adhesion,adhesion to surrounding organs,gallbladder wall thickness≥5 mm,and electrocautery in Calot's triangle as independent risk factors(all P<0.05).The regression equation was:Logit(P)=-9.126+1.362×gallbladder neck stones+0.784×CBD diameter+1.695×adhesion to surrounding organs+1.108×electrocautery+0.895×Calot adhesion+0.679×anatomical variation+0.559×wall thickness.The model showed good discrimination with an AUC of 0.903,sensitivity of 82.72%,and specificity of 84.44%.
Conclusion:Multiple anatomical and intraoperative factors are associated with bile leakage after LC.The proposed regression model demonstrates good predictive performance and may assist in perioperative risk assessment.关键词
胆囊切除术,腹腔镜/胆汁漏/危险因素/Logistic模型Key words
Cholecystectomy,Laparoscopic/Bile Leakage/Risk Factors/Logistic Models分类
医药卫生引用本文复制引用
王松,李权,刘建,朱征全,刘甫..腹腔镜胆囊切除术后胆汁漏的危险因素分析及预测模型构建[J].中国普通外科杂志,2026,35(2):298-305,8.
