ERCP术后胆总管结石复发的危险因素分析

王梦洁; 王启之; 燕善军; 郑海伦; 邓晓晶; 李大鹏

doi:10.13898/j.cnki.issn.1000-2200.2022.05.007

ERCP术后胆总管结石复发的危险因素分析

Analysis of the risk factors of common bile duct stones recurrence after ERCP

摘要

摘要:
目的分析胆总管结石病人经内镜下逆行胰胆管造影术(ERCP)治疗后结石复发的相关危险因素。
方法将行ERCP取石术的256例胆总管结石病人纳入研究，随访6个月以上。将复发的17例作为复发组，其余239例作为非复发组，回顾性分析2组病人在一般情况、胆道情况、结石情况、实验室检查、手术方式等方面的差异。
结果2组病人在年龄、胆囊切除术史、胆总管直径、结石大小、结石数量方面差异均有统计学意义(P < 0.05~P < 0.01)。Logistic回归分析显示，有胆囊切除术史、最大结石直径越大、结石数量≥2是ERCP术后结石复发的独立危险因素(P < 0.05~P < 0.01)。
结论对于年龄大、有胆囊切除术史、胆总管直径较宽、结石直径大、数量多的病人一定要做好术前评估，术中规范，术后预防，加强随访来减少结石复发。

Abstract:
ObjectiveTo analyze the risk factors of stone recurrence in patients with common bile duct stone after endoscopic retrograde cholangiopancreatography(ERCP).
MethodsA total of 256 patients with common bile duct stone treated with ERCP were selected, and all patients were followed up for more than 6 months.The 17 patients with recurrence and 239 patients without recurrence were divided into the recurrence group and non-recurrence group, respectively.The general conditions, biliary tract conditions, calculus conditions, laboratory tests and surgery method in two groups were retrospectively analyzed.
ResultsThe differences of the age, history of cholecystectomy, diameter of common bile duct, stone size and number of stones between two groups were statistically significant(P < 0.05 to P < 0.01).The results of logistic regression analysis showed that the history of cholecystectomy, large stone diameter and stone number ≥2 were the independent risk factors of stone recurrence after ERCP(P < 0.05 to P < 0.01).
ConclusionsFor patients with older age, history of cholecystectomy, wide diameter of common bile duct, large stone diameter and large number, the preoperative evaluation, intraoperative specification, postoperative prevention and enhanced follow-up must be done to reduce the recurrence of stones.

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