胆总管结石行内镜下逆行胰胆管造影术治疗后结石复发的相关危险因素分析

Analysis of related risk factors in patients with choledocholithiasis following endoscopic retrograde cholangiopancreatography

目的对影响胆总管结石(CBDS)患者行内镜下逆行胰胆管造影(ERCP)术治疗后结石复发的相关危险因素进行研究并分析。方法选取2014年3月至2017年3月在上海第六人民医院行ERCP术治疗的患者200例,将术后CBDS复发86例患者作为观察组,术后CBDS未复发114例作为对照组,结合两组患者资料进行单因素分析,对筛选出的危险因素进一步行多因素Logistic回归分析。结果观察组患者年龄、病程、胆总管直径、有胆道手术史、胆道狭窄、有乳头旁憩室、结石大小(≥10 mm)、结石数量(≥2枚)的例数均显著多于对照组,差异有统计学意义(均P<0.05);多因素分析显示,年龄、有胆道手术史、乳头旁憩室、结石数量≥2枚、胆总管直径、结石大小(直径≥10 mm)为患者术后复发的独立危险因素(P<0.05)。结论患者年龄、有既往胆道手术史、合并乳头旁憩室、结石数量≥2枚、胆总管直径≥10 mm是CBDS胰胆管造影术后复发独立危险因素。

Objective To study and analyze the related risk factors associated with stone recurrence after endoscopic retrograde cholangiopancreatography（ERCP） in patients with common bile duct stones（CBDS）. Methods From March 2014 to March 2017 in the 6 th People＇s Hospital of Shanghai, two hundred patients treated with cholangiopancreatography were divided into two groups, with postoperative CBDS recurrence in 86 patients as the observation group, no postoperative CBDS recurrence in 114 patients as the control group. Univariate analysis was performed for two groups, and multivariate logistic regression analysis was used to screen out the risk factors. Results Age, duration, the diameter of the common bile duct, biliary surgery, biliary stricture, diverticula, stone size（≥10 mm）, the number of stones（more than 2） in the observation group were significantly higher than that in the control group, respectively, the differences were statistically significant（all P0.05）. Multivariate analysis showed that age, history of biliary surgery, peripapillary diverticulum, the number of stones more than 2 pieces, common bile duct diameter, and stone size（diameter≥10 mm） were the independent risk factors of postoperative recurrence in CBDS patients（P0.05）. Conclusion Age, history of biliary tract surgery, combined diverticula, more than 2 pieces of stones, and common bile duct diameter more than 10 mm are the independent risk factors of the recurrence of post ERCP in CBDS.