腹腔镜胆囊切除术胆管损伤相关危险因素分析

Associated risk factors of laparoscopic cholecystectomy bile duct injury

目的分析腹腔镜胆囊切除术(LC)导致胆管损伤的相关危险因素。方法选择本院2008年1月～2012年12月收治的859例胆囊炎和胆囊结石患者,回顾性分析医源性胆管损伤的发生原因。结果医源性胆管损伤患者25例(占2.9%),医源性胆管损伤与患者性别无明显关系(P>0.05);年龄>40岁的患者医源性胆管损伤发病率明显高于≤40岁的患者(P<0.05);急性胆囊炎患者的发病率明显高于非急性胆囊炎患者的发病率;胆囊结石患者中合并积液患者的发病率明显高于单纯性患者(P<0.05)。结论 LC导致的医源性胆管损伤主要与年龄、原发病情况有关。

Objective To analyze the associated risk factors of bile duct injury caused by laparoscopic cholecystecto- my.Methods 859 cases of patients with cholecystitis and gallbladder stones admitted to our hospital from January 2008 to December 2012 were selected,in which included 25 cases of iatrogenic bile duct injury,the causes of iatrogenic bile duct injury was analyzed retrospectively. Results There were 25 cases of patients with iatrogenic bile duct injuryed（ac- counted for 2.9%）.There was no obvious connection between the iatrogenic bile duct injury and the gender of patients （P〉0.05）.The iatrogenic bile duct injury incidence of patients （〉40 years old） was significantly higher than that of pa- tients ≤40 years old（P〈0.05）.The incidence of acute cholecystitis patients was significantly higher than the incidence of patients with acute cholecystitis.The gallstone patients combined with effusion were signifihantly higher than the in- cidence of simple patients （P〈0.05）. Conclusion The risk factors which lead to iatrogenic bile duct injury in laparo- scopic cholecystectomy are relate to age and primary illness.