胆总管结石ERCP治疗后复发的危险因素分析
|
摘要
目的研究胆总管结石经ERCP取石术后复发的相关危险因素。方法方便收集该院2009年9月—2014年9月期间进行ERCP胆总管取石患者的相关资料,包括性别、年龄、胆囊切除术、胆总管多发结石、胆总管直径,对其进行回顾性分析。采用χ2检验筛选出胆总管结石ERCP术后复发的相关危险因素,后采用多因素Logistic回归统计分析胆总管结石ERCP术后复发的独立危险因素。结果共纳入276例患者,有23例复发,复发率8.3%。提示胆囊切除术后、多发结石与结石复发相关。Logistic回归分析提示胆囊切除术后为结石复发的独立危险因素。结论胆囊切除术后为胆总管结石ERCP术后复发的独立危险因素。
Objective To investigate the risk factors for recurrence of common bile duct stones after treatment with ERCP.Methods Data of patients with ERCP choledocholithotomy from September 2009 to September 2014 were convenient collected, including gender, age, cholecystectomy, common bile duct stones and common bile duct diameter. χ2 test was used to select the related risk factors of postoperative recurrence of common bile duct calculi ERCP, and multivariate Logistic regression was used to analyze the independent risk factors of postoperative recurrence of common bile duct calculi ERCP.Results A total of 276 patients were included, and 23 of them had recurrence, and the recurrence rate was 8.3%. Logistic regression analysis suggested that cholecystectomy was an independent risk factor for stone recurrence. Conclusion Cholecystectomy is an independent risk factor for the recurrence of CBD stones.
Objective To investigate the risk factors for recurrence of common bile duct stones after treatment with ERCP.Methods Data of patients with ERCP choledocholithotomy from September 2009 to September 2014 were convenient collected, including gender, age, cholecystectomy, common bile duct stones and common bile duct diameter. χ2 test was used to select the related risk factors of postoperative recurrence of common bile duct calculi ERCP, and multivariate Logistic regression was used to analyze the independent risk factors of postoperative recurrence of common bile duct calculi ERCP.Results A total of 276 patients were included, and 23 of them had recurrence, and the recurrence rate was 8.3%. Logistic regression analysis suggested that cholecystectomy was an independent risk factor for stone recurrence. Conclusion Cholecystectomy is an independent risk factor for the recurrence of CBD stones.
引文
[1]赖晓伟,周玮,刘杰,等.胆总管结石内镜治疗复发的危险因素分析[J].中华消化内镜杂志,2015,32(9):600-603.
[2]Park JS,Jeong S,Bang BW,et al.Endoscopic Papillary Large Balloon Dilatation Without Sphincterotomy for the Treatment of Large Common Bile Duct Stone:Long-Term Outcomes at a Single Center[J].Dig Dis Sci,2016,61(10):3045-3053.
[3]Cotton PB,Geeneb JE,Sherman S et al.endoscopic sphincterotomy for stones by experts is safe,even in younger patients with normal ducts[J].Ann Surg,1998,227:201-204.
[4]Costamagna G,Tringali A,Shah SK,et al.Long-term follow-up of patients after endoscopic sphincterotomy for choledocholithiasis,and risk factors for recurrence[J].Endoscopy,2002,34(4):273-279.
[5]Paspatis GA1,Paraskeva K2,Vardas E3,et al.Long-term recurrence of bile duct stones after endoscopic papillary large balloon dilation with sphincterotomy:4-year extended follow-up of a randomized trial[J].Surg Endosc,2017,31(2):650-655.
[6]Li S1,Su B,Chen P,et al.Risk factors for recurrence of common bile duct stones after endoscopic biliary sphincterotomy[J].AbstractJ Int Med Res,2018,46(7):2595-2605.
[7]Paik WH,Ryu JK,Park JM,et al.Which is the better treatment for the removal of large biliary stones Endoscopic papillary large balloon dilation versus endoscopic sphincterotomy[J].Gut Liver,2014,8(4):438-444.
[8]Nzenza TC,Al-Habbal Y,Guerra GR et al.Recurrent common bile duct stones as a late complication of endoscopic sphincterotomy[J].BMC Gastroenterol,2018,15,18(1):39.
[9]Park BK1,Seo JH2,Jeon HH1,et al.A nationwide population-based study of common bile duct stone recurrence after endoscopic stone removal in Korea[J].J Gastroenterol,2018,53(5):670-678.
[10]Sun Z1,Bo W1,Jiang P1,et al.Different Types of Periampullary Duodenal Diverticula Are Associated with Occurrence and Recurrence of Bile Duct Stones:A CaseControl Study from a Chinese Center[J].Gastroenterol Res Pract,2016,2016:9381759.
[11]Yamamoto R1,Tazuma S2,Kanno K1,et al.Ursodeoxycholic acid after bile duct stone removal and risk factors for recurrence:a randomized trial[J].J Hepatobiliary Pancreat,2016,23(2):132-136.
[12]Song ME,Chung MJ,Lee DJ,et al.Cholecystectomy for Prevention of Recurrence after Endoscopic Clearance of Bile Duct Stonesin Korea[J].Yonsei Med J,2016,57(1)132-137.
[2]Park JS,Jeong S,Bang BW,et al.Endoscopic Papillary Large Balloon Dilatation Without Sphincterotomy for the Treatment of Large Common Bile Duct Stone:Long-Term Outcomes at a Single Center[J].Dig Dis Sci,2016,61(10):3045-3053.
[3]Cotton PB,Geeneb JE,Sherman S et al.endoscopic sphincterotomy for stones by experts is safe,even in younger patients with normal ducts[J].Ann Surg,1998,227:201-204.
[4]Costamagna G,Tringali A,Shah SK,et al.Long-term follow-up of patients after endoscopic sphincterotomy for choledocholithiasis,and risk factors for recurrence[J].Endoscopy,2002,34(4):273-279.
[5]Paspatis GA1,Paraskeva K2,Vardas E3,et al.Long-term recurrence of bile duct stones after endoscopic papillary large balloon dilation with sphincterotomy:4-year extended follow-up of a randomized trial[J].Surg Endosc,2017,31(2):650-655.
[6]Li S1,Su B,Chen P,et al.Risk factors for recurrence of common bile duct stones after endoscopic biliary sphincterotomy[J].AbstractJ Int Med Res,2018,46(7):2595-2605.
[7]Paik WH,Ryu JK,Park JM,et al.Which is the better treatment for the removal of large biliary stones Endoscopic papillary large balloon dilation versus endoscopic sphincterotomy[J].Gut Liver,2014,8(4):438-444.
[8]Nzenza TC,Al-Habbal Y,Guerra GR et al.Recurrent common bile duct stones as a late complication of endoscopic sphincterotomy[J].BMC Gastroenterol,2018,15,18(1):39.
[9]Park BK1,Seo JH2,Jeon HH1,et al.A nationwide population-based study of common bile duct stone recurrence after endoscopic stone removal in Korea[J].J Gastroenterol,2018,53(5):670-678.
[10]Sun Z1,Bo W1,Jiang P1,et al.Different Types of Periampullary Duodenal Diverticula Are Associated with Occurrence and Recurrence of Bile Duct Stones:A CaseControl Study from a Chinese Center[J].Gastroenterol Res Pract,2016,2016:9381759.
[11]Yamamoto R1,Tazuma S2,Kanno K1,et al.Ursodeoxycholic acid after bile duct stone removal and risk factors for recurrence:a randomized trial[J].J Hepatobiliary Pancreat,2016,23(2):132-136.
[12]Song ME,Chung MJ,Lee DJ,et al.Cholecystectomy for Prevention of Recurrence after Endoscopic Clearance of Bile Duct Stonesin Korea[J].Yonsei Med J,2016,57(1)132-137.