胆囊结石术后并发胰腺炎的危险因素分析及防治建议

Risk factors analysis and prevention and treatment suggestions of pancreatitis after cholecystolithiasis surgery

目的探讨胆囊结石术后并发胰腺炎的危险因素,并提出对应防治建议。方法回顾性分析在我院行胆囊切除术的122例患者的临床资料。将发生胰腺炎的记为发生组,未发生的为未发生组,分析胰腺炎的危险因素。结果122例患者中,术后并发胰腺炎18例,发生率为14.75%;发生组年龄<60岁、泥沙样结石、胰腺病史、插管次数≥3、胰管显影、手术切口大、乳头旁憩室占比均显著高于未发生组(P<0.05);经Logistic回归分析结果显示,年龄<60岁、泥沙样结石、胰腺病史、插管次数≥3、胰管显影、手术切口大、乳头旁憩室均为胆囊结石术后并发胰腺炎的独立危险因素(P<0.05)。结论年龄<60岁、泥沙样结石、胰腺病史、插管次数≥3、胰管显影、手术切口大、乳头旁憩室均为胆囊结石术后并发胰腺炎的独立危险因素,临床需采取针对性防治措施。

Objective To investigate the risk factors of pancreatitis after cholecystolithiasis surgery and to propose corresponding prevention and treatment suggestions.Methods The clinical data of 122 patients undergoing cholecystectomy in our hospital were retrospectively analyzed.Patients with pancreatitis were recorded as occurrence group and those without pancreatitis as non-occurrence group,and the risk factors of pancreatitis were analyzed.Results Of the 122 patients,18 cases were complicated with pancreatitis after operation,with an incidence of 14.75%.The proportions of age<60 years old,sediment-like stones,history of pancreatic disease,number of intubation≥3,pancreatic duct visualization,large incision and parapapillary diverticulum of the occurrence group were higher than those of the non-occurrence group(P<0.05).The Logistic regression analysis showed that age<60 years old,sediment-like stones,history of pancreatic disease,number of intubation≥3,pancreatic duct visualization,large incision and parapapillary diverticulum were all independent risk factors for pancreatitis after cholecystolithiasis surgery(P<0.05).Conclusion Age<60 years old,sediment-like stones,history of pancreatic disease,number of intubation≥3,pancreatic duct visualization,large incision and parapapillary diverticulum are all independent risk factors for pancreatitis after cholecystolithiasis surgery,and targeted prevention and treatment measures should be taken in clinic.