腹腔镜下胆总管切开探查一期缝合术后胆漏相关因素的Logistic回归分析

Logistic regression analysis on correlated factors of bile leakage after laparoscopic choledochotomy with exploration and primary suture

目的探讨腹腔镜下胆总管切开一期缝合术后胆漏发生的相关因素。方法通过对我院收治的腹腔镜下胆总管切开一期缝合术后发生胆漏的19例患者和52例未发生胆漏的对照者进行病例对照研究,以多因素非条件Logistic回归法分析相关的危险因素。结果一期缝合术后胆漏的发生与体重指数、胆总管切开方式、白蛋白、糖尿病有关,两组间比较差异有统计学意义(P<0.05),与性别、年龄及手术时间无关(P>0.05),多因素Logistic回归分析结果显示,胆总管切开方式、白蛋白、体重指数是是胆总管切开一期缝合术后发生胆漏的主要危险因素,而胆总管切开方式对术后胆漏的发生影响最大。结论严格把握适应症及正确的手术操作是减少一期缝合术后胆漏发生的关键。

Objective To explore the risk factors of bile leakage after laparoscopic choledochotomy with exploration and primary suture. Methods The clinical data of 19 patients with bile leakage and 52 without bile leakage after laparoscopic choledochotomy with exploration and primary suture were studied retrospectively..And the related risk factors of bile leakage were analyzed with unconditional multivariate Logistic regression analysis. Results Bile leakage after primary suture were associated with the body metabolic index,.manner of common bile duct incision ,.level of serum albumin and diabetes , which were statistically significant differences between two group （P0.05） and the improper manner of common bile duct incision was the most important factor. Conclusion The strict indication control and the correct surgical procedure are the keys to reduce bile leakage occurrence after primary suture on common bile duct.