腹腔镜胆囊切除术并发症发生的相关影响因素分析

发布时间：2018-04-15 07:41

本文选题：胆囊切除术 + 腹腔镜　；参考：《中国普通外科杂志》2016年02期

【摘要】：目的:分析腹腔镜胆囊切除术(LC)并发症的各种危险因素。方法:收集2012年9月—2014年9月期间院行LC术的312例患者临床资料,分析术后出现并发症发生情况及相关危险因素。结果:共有81例患者出现并发症(25.96%),其中胆囊破裂22例(7.05%),腹腔出血28例(8.97%),肝动脉损伤17例(5.45%),胆瘘14例(4.48%);单因素分析结果显示,Calot三角粘连、解剖变异、急性期、Calot三角区电灼及胆囊壁厚度超过5 mm与LC并发症的发生有关(均P0.05);多因素分析结果显示,Calot三角出现粘连(OR=3.466,95%CI=1.432~8.389)、局部解剖变异(OR=1.988,95%CI=1.237~3.194)及术中采取Calot三角电灼切除(OR=1.089,95%CI=1.015~1.168)是LC并发症发生的独立危险因素(均P0.05)。结论:LC术前应完善相关检查,了解患者存在的危险因素,避免使用Calot三角区电灼切除,以减少术后并发症的发生。
[Abstract]:Objective: to analyze the risk factors of LC complications in laparoscopic cholecystectomy.Methods: the clinical data of 312 patients undergoing LC from September 2012 to September 2014 were collected and the incidence of postoperative complications and related risk factors were analyzed.Results: a total of 81 patients had complications, including 22 cases of gallbladder rupture, 28 cases of abdominal hemorrhage, 17 cases of hepatic artery injury, and 14 cases of biliary fistula, among which 22 cases had rupture of gallbladder, 28 cases had intraperitoneal hemorrhage, 17 cases had hepatic artery injury, and 14 cases had biliary fistula, the results of univariate analysis showed Calot triangle adhesion and anatomic variation.The results of multivariate analysis showed that the complications of LC were associated with electrocautery of Calot triangle and thickness of gallbladder wall more than 5 mm in acute phase (all P0.05; multivariate analysis showed that there was a conglutination of ORT 3.466 ~ 95CII 1.432C 8.389m, local anatomical variation OR1.988995 CI1.2373.194) and Calot triangle cauterization of OR1.089C95CI1.015151.168 during operation.The independent risk factors of LC complications (all P 0.05).Conclusion the relevant examinations should be improved before the operation to understand the risk factors of the patients and avoid the use of Calot trigonometric electrocautery in order to reduce the incidence of postoperative complications.
【作者单位】：中国人民解放军第一七五医院普通外科;
【分类号】：R657.4

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