腹腔镜胆囊切除术后并发症发生的相关因素分析

Analysis of related factors of complications after laparoscopic cholecystectomy

目的探讨腹腔镜胆囊切除术后并发症发生的相关因素分析。方法回顾性分析2018年6月至2020年9月本院收治500例行腹腔镜胆囊切除术患者的临床资料,采用单因素及多因素Logistic回归分析胆囊结石患者发生术后并发症的影响因素。结果500例患者中,发生并发症38例,未发生并发症462例。单因素分析结果显示,胆囊壁厚度>5 cm、有组织粘连、有Calot三角粘连、即刻手术、有局部解剖变异、有胆囊颈部结石、肝功能异常、伴有急性炎症均为胆囊结石患者发生术后并发症的影响因素(P<0.05)。多因素Logistic回归分析结果显示,胆囊壁厚度>5 cm、有组织粘连、有Calot三角粘连、即刻手术、局部解剖变异、伴有急性炎症均为影响胆囊切除术后发生并发症的独立危险因素(OR>1,P<0.05)。结论胆囊结石患者发生术后并发症的危险因素有胆囊壁厚度>5 cm、有组织粘连、有Calot三角粘连、即刻手术、局部解剖变异、伴有急性炎症,可根据以上危险因素制订针对性治疗方案,改善患者预后。

Objective To investigate the analysis of related factors of complications after laparoscopic cholecystectomy.Methods The clinical data of 500 patients undergoing laparoscopic cholecystectomy treated in our hospital from June 2018 to September 2020 were retrospectively analyzed.Univariate and multivariate Logistic regression were used to analyze the influencing factors of postoperative complications in patients with cholecystolit hiasis.Results Among the 500 patients,38 cases had complications and 462 cases did not have complications.The results of univariate analysis showed that factors such as gallbladder wall thickness>5 cm,tissue adhesion,Calot's triangle adhesion,immediate operation time,local anatomical variation,presence of gallbladder neck stones,abnormal liver function,and acute inflammation were significantly associated with the occurrence of postoperative complications in patients with gallstones(P<0.05).Multivariate Logistic regression analysis showed that gallbladder wall thickness>5 cm,tissue adhesion,Calot's triangle adhesion,immediate operation time,local anatomical variation,and acute inflammation were independent risk factors for complications after cholecystectomy(OR>1,P<0.05).Conclusion The risk factors for the occurrence of postoperative complications in patients with gallstones include gallbladder wall thickness>5 cm,tissue adhesion,Calot's triangle adhesion,immediate operation,local anatomical variation,and presence of acute inflammation,treatment plans can be tailored based on these risk factors to improve patient outcomes.