摘要
目的分析BillrothⅡ胃切除术后胆总管结石复发的影响因素。方法回顾性分析北部战区总医院自2012年1月至2020年8月收治的BillrothⅡ胃切除术后接受经内镜逆行胰胆管造影术治疗胆总管结石并确定结石被彻底清除的131例患者的临床资料。根据胆总管结石是否复发,将患者分入复发组(n=25)和非复发组(n=106)。采用单因素分析和多因素Logistic回归分析探究BillrothⅡ胃切除术后胆总管结石复发的独立危险因素。结果两组胆总管形态和胆总管直径≥1.5 cm所占比例比较,差异有统计学意义(P<0.05)。胆总管直径≥1.5 cm是BillrothⅡ胃切除术后胆总管结石复发的独立危险因素(比值比7.56,95%可信区间2.00~28.49,P<0.05)。胆总管形态也是BillrothⅡ胃切除术后胆总管结石复发的独立危险因素(P<0.05),且S型复发概率是直线型的14.60倍(比值比14.60,95%可信区间3.77~56.60,P<0.05),折线型复发概率是直线型的3.89倍(比值比3.89,95%可信区间1.15~13.21,P<0.05),S型复发概率是折线型的3.75倍(比值比3.75,95%可信区间1.06~13.26,P<0.05)。结论胆总管直径≥1.5 cm和胆总管形态(特别是S型和折线型)会增加BillrothⅡ胃切除术后胆总管结石复发的风险。
Objective To analyze the factors influencing the recurrence of choledocholithiasis after BillrothⅡgastrectomy.Methods The clinical data of 131 patients with choledocholithiasis treated by endoscopic retrograde cholangiopancreatography(ERCP)after BillrothⅡgastrectomy in General Hospital of Northern Theater Command from January 2012 to August 2020 were retrospectively analyzed.Patients were divided into recurrence group(n=25)and non-recurrence group(n=106)according to whether choledocholithiasis recurred.Univariate analysis and multivariate Logistic regression analysis were used to investigate the independent risk factors for recurrent choledocholithiasis after BillrothⅡgastrectomy.Results There were statistically significant differences in proportion ofcommon bile duct morphology and common bile duct diameter≥1.5 centimeters between the two groups(P<0.05).Common bile duct diameter≥1.5 centimeters was an independent risk factor for recurrence of choledocholithiasis after BillrothⅡgastrectomy(odds ratio 7.56,95%confidence interval 2.00-28.49,P<0.05).The common bile duct morphology was also an independent risk factor for the recurrence of choledocholithiasis after BillrothⅡgastrectomy(P<0.05),and the probability of s-type recurrence was 14.60 times higher than that of straight-type recurrence(odds ratio 14.60,95%confidence interval 3.77-56.60,P<0.05),the recurrence probability of bent-type was 3.89 times higher than that of straight-type(odds ratio 3.89,95%confidence interval 1.15-13.21,P<0.05),and that of s-type was 3.75 times higher than that of bent-type(odds ratio 3.75,95%confidence interval 1.06-13.26,P<0.05).Conclusion Common bile duct diameter≥1.5 centimeters and common bile duct morphology(especially s-type and bent-type)increase the risk of recurrent choledocholithiasis after BillrothⅡgastrectomy.
作者
冀旭
刘传宏
曲颖
麻树人
贾雯
赵倩
王瑶
徐璐
阚莹
曹阳
杨卓
JI Xu;LIU Chuan-hong;QU Ying;MA Shu-ren;JIA Wen;ZHAO Qian;WANG Yao;XU Lu;KAN Ying;CAO Yang;YANGZhuo(Department of Endoscopy,General Hospital of Northern Theater Command,Shenyang 110016,China;Department of Military Health Service,General Hospital of Northern Theater Command,Shenyang 110016,China;Outpatient Department,Shenyang No.1 Retirement Rest Center of Liaoning Military Region,Shenyang 110058,China)
出处
《临床军医杂志》
CAS
2022年第2期145-148,共4页
Clinical Journal of Medical Officers
作者简介
第一作者:冀旭(1995-),女,山东即墨人,医师;通信作者:杨卓,E-mail:yangzhuocy@163.com
