胆总管结石ERCP治疗后复发情况及其影响因素

The Recurrence of Choledocholithiasis after ERCP Treatment and Its Influencing Factors

目的:研究胆总管结石患者经内镜逆行性胰胆管造影(ERCP)治疗后复发情况及其影响因素,为胆总管结石ERCP治疗后复发的预防提供依据。方法:回顾性分析2017年1月-2020年4月在笔者所在医院行ERCP治疗的80例胆总管结石患者的临床资料。所有患者均行ERCP治疗,术后随访7个月。统计患者术后复发情况,并填写所有患者性别、疾病类型、胆道感染情况、结石数量、胆总管扩张情况、手术方式、胆道积气情况、既往病史及体质指数,分析胆总管结石ERCP治疗后复发情况的影响因素。结果:随访7个月,80例行ERCP治疗的胆总管结石患者中复发17例,复发率为21.25%;经单因素分析结果显示,胆总管结石ERCP治疗后复发情况不受性别、疾病类型、胆道感染、手术方式及既往病史的影响(P>0.05),但可能受胆道积气、结石数量、胆总管扩张及体质指数的影响(P<0.05);多项Logistic回归分析发现,有胆道积气、结石数量≥2个、存在胆总管扩张、体质指数≥25 kg/m^(2)是胆总管结石ERCP治疗后复发情况的影响因素(OR>1,P<0.05)。结论:胆道积气、结石数量≥2个、存在胆总管扩张、体质指数≥25 kg/m~2是胆总管结石ERCP治疗后复发的影响因素。

Objective:To study the recurrence of patients with choledocholithiasis after endoscopic retrograde cholangiopancreatography(ERCP)treatment and its influencing factors,so as to provide evidence for the prevention of recurrence after ERCP treatment of choledocholithiasis.Method:The clinical data of 80 patients with common bile duct stones who underwent ERCP treatment in our hospital from January 2017 to April 2020 were retrospectively analyzed.All patients underwent ERCP treatment and followed up for 7 months.After 7 months of follow-up,the postoperative recurrence of the patients was counted,and all patients’gender,disease type,biliary infection,number of stones,common bile duct dilatation,operation method,biliary pleuralgia,past medical history and body mass index were analyzed,as well as influencing factors of recurrence after ERCP treatment of common duct stones.Result:After 7 months of follow-up,17 of the 80 patients with choledocholithiasis treated with ERCP had recurrence,with a recurrence rate of 21.25%.The univariate analysis showed that the recurrence of choledocholithiasis after ERCP treatment was independent of gender and disease type,biliary tract infection,surgical methods,and previous medical history(P>0.05),but may be affected by biliary gas,the number of stones,common bile duct dilation,and body mass index(P<0.05);multiple logistic regression analysis found that biliary tract,number of stones≥2,the presence of common bile duct dilation,and the body mass index≥25 kg/m^(2) were the influencing factors for the recurrence of common bile duct stones after ERCP treatment(OR>1,P<0.05).Conclusion:Biliary tract,the number of stones≥2,the presence of common bile duct dilatation,and the body mass index≥25 kg/m2 are the influencing factors for the recurrence of common bile duct stones after ERCP treatment.