十二指肠镜治疗胆总管结石后复发因素分析

Risk factors of recurrent common bile duct stones after duodenoscopic surgery

目的探讨经内镜下乳头括约肌切开术(endoscopic sphincterotomy,EST)治疗胆总管结石后复发的相关因素。方法收集成都军区总医院消化内科2004年1月-2008年5月资料完整采用EST治疗的胆总管结石患者526例,胆总管复发相关因素采用Logistic回归分析。结果 526例患者随访32～72个月,平均46.3±11.5个月,65例(12.4%)胆总管结石复发。Logistic回归分析显示老年患者(年龄>65岁)、合并胆囊结石、胆总管扩张(直径>1.5 cm)、十二指肠乳头大切开、十二指肠乳头旁憩室与胆总管结石复发相关。结论老年患者、胆囊结石、胆总管扩张、十二指肠乳头大切开、十二指肠乳头旁憩室与胆总管结石复发相关。

Objective To investigate the risk factors of recurrent common bile duct（CBD） stones after treatment with endoscopic sphincterotomy （EST）. Methods Total of 526 patients with CBD stone from Jan. 2004 to May. 2008 who had complete follow-up data in General Hospital of Chengdu Military Region were recruited to the study. The CBD stone recurrent frequency and the possible risk factors were calculated with logistic regression analysis. Results The patients were followed up 32 ~ 72 months （at a mean duration of 46.3 ± 11.5 months）, and CBD stone reoccurred in 65 cases （12.4%）. Logistic regression analysis showed elderly （ 〉 65 years old） , choledochectasia （more than 1.5 cm in diam- eter）, cholecystolithiasis, periampullary diverticula, large endoscopic sphincterotomy were risk factors of recurrence CBD. Conclusion Elderly, choledochectasia, cholecystolithiasis, periampullary diverticula, large endoscopic sphinc- terotomy are related to recurrence of CBD.