Analysis of risk factors for bile leakage after laparoscopic common bile duct exploration with primary closure

GUO Wu; LIU Jun-jian; SHANG Hai-tao; ZHANG De-lin; ZHANG Xi-bo; LI Zhong-lian

doi:10.11659/jjssx.06E024022

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Analysis of risk factors for bile leakage after laparoscopic common bile duct exploration with primary closure

Gastroenterology and Hepatobiliology | 更新时间：2024-10-22

- Analysis of risk factors for bile leakage after laparoscopic common bile duct exploration with primary closure
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 33, Issue 10, Pages: 844-848(2024)
- 作者机构：
  
  1.天津市海河医院普通外科，天津 300222
  2.天津市中西医结合医院肝胆胰外科二，天津 300100
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.06E024022
  CLC： R619+.9
- Published：25 October 2024，
  
  Received：06 June 2024，
- 稿件说明：
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郭午,刘军舰,尚海涛等.腹腔镜下胆总管探查术一期缝合后胆漏的危险因素分析[J].局解手术学杂志,2024,33(10):844-848.

GUO Wu,LIU Jun-jian,SHANG Hai-tao,et al.Analysis of risk factors for bile leakage after laparoscopic common bile duct exploration with primary closure[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(10):844-848.
郭午,刘军舰,尚海涛等.腹腔镜下胆总管探查术一期缝合后胆漏的危险因素分析[J].局解手术学杂志,2024,33(10):844-848. DOI： 10.11659/jjssx.06E024022.

GUO Wu,LIU Jun-jian,SHANG Hai-tao,et al.Analysis of risk factors for bile leakage after laparoscopic common bile duct exploration with primary closure[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(10):844-848. DOI： 10.11659/jjssx.06E024022.

摘要

目的

探讨腹腔镜下胆总管探查术（LCBDE）一期缝合后胆漏发生的危险因素。

方法

回顾性分析2021年9月至2023年9月因胆总管结石于天津市中西医结合医院行LCBDE一期缝合的560例患者的临床资料，根据术后是否发生胆漏将患者分为胆漏组和未胆漏组。多因素分析影响术后胆漏发生的危险因素。

结果

共64例（11.4%）患者发生了不同程度的胆漏，其中A级胆漏55例，B级7例，C级2例。胆总管直径较小（

=0.07，

0.001）、高血压史（

=4.56，

0.001）及BMI较高（

=1.17，

=0.002）是胆总管结石患者术后胆漏发生的危险因素。

结论

胆总管直径较小、合并高血压和肥胖的患者术后更易发生胆漏，对于存在上述危险因素的胆总管结石患者，应谨慎选择LCBDE一期缝合。

Abstract

Objective

To explore the risk factors for bile leakage after laparoscopic common bile duct exploration （LCBDE） with primary closure.

Methods

The clinical data of 560 patients with choledocholithiasis who underwent LCBDE with primary closure in Tianjin Hospital of Integrated Traditional Chinese and Western Medicine from September 2021 to September 2023 were retrospectively analyzed， and the patients were divided into the bile leak group and the non-bile leak group according to the occurrence of postoperative bile leakage. The risk factors affecting the occurrence of postoperative bile leakage were analyzed by multivariate analysis.

Results

A total of 64 cases （11.4%） experienced varying degrees of bile leakage， including 55 cases of grade A bile leakage， 7 cases of grade B， and 2 cases of grade C. The thin common bile duct （

=0.07，

0.001）， history of hypertension （

=4.56，

0.001）， and high BMI （

=1.17，

=0.002） were the risk factors for postoperative bile leakage in patients with choledocholithiasis.

Conclusion

Patients with thin common bile duct， hypertension and obesity are more likely to occur postoperative bile leakage. Patients with choledocholithiasis who have the above high-risk factors should be cautious in choosing LCBDE with primary closure.

关键词

腹腔镜胆总管一期缝合胆漏危险因素胆总管结石

Keywords

laparoscopeprimary closure of common bile ductbile leakagerisk factorscholedocholithiasis

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