腹腔镜胆囊切除术患者并发胆管损伤的影响因素

The Influencing Factors of Bile Duct Injury in Patients with Laparoscopic Cholecystectomy

目的分析腹腔镜胆囊切除术(LC)患者并发胆管损伤的影响因素。方法回顾性分析2020年2月至2021年12月医院收治的35例并发胆管损伤的LC患者的临床资料,纳入发生组;另收集同期35例未并发胆管损伤的LC患者的临床资料,纳入未发生组。比较两组一般资料,分析LC患者并发胆管损伤的影响因素。结果两组胆囊三角解剖、术者经验、胆囊壁厚度、合并肝硬化情况比较,差异有统计学意义(P<0.05);Logistic回归分析结果显示,胆囊三角解剖异常、术者经验缺乏、胆囊壁厚度较大、合并肝硬化是LC患者并发胆管损伤的危险因素(OR>1,P<0.05)。结论LC患者并发胆管损伤受胆囊三角解剖异常、术者经验缺乏、胆囊壁厚度较大、合并肝硬化等因素影响,临床可据此采取有效预防措施,以保证LC治疗效果,改善患者预后。

Objective The influencing factors of bile duct injury in patients with laparoscopic cholecystectomy(LC)were analyzed.Methods With retrospective analysis of the clinical data of 35 patients undergoing LC complicated with bile duct injury admitted to the hospital from February 2020 to December 2021 to include them in the occurring group,and collection of clinical data of 35 LC patients without bile duct injury during the same period to include them in the non-occurring group,the general data of the two groups were compared,and the influencing factors of bile duct injury in LC patients were analyzed.Results There were statistically significant differences in the anatomy of the gallbladder triangle,the experience of the surgeon,the thickness of the gallbladder wall,and the presence of cirrhosis between the two groups(P<0.05);The results of Logistic regression analysis showed that abnormal anatomy of the gallbladder triangle,lack of surgical experience,large gallbladder wall thickness,and cirrhosis were risk factors for bile duct injury in LC patients(OR>1,P<0.05).Conclusion LC patients with bile duct injury are influenced by factors such as abnormal anatomy of the gallbladder triangle,lack of surgical experience,large thickness of the gallbladder wall,and cirrhosis.Effective preventive measures can be taken based on the above factors in clinical practice to ensure the effectiveness of LC treatment and improve patient prognosis.