Risk factors for long-term complications after endoscopic sphincterotomy for benign biliary and pancreatic diseases
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摘要: 目的分析良性胆胰疾病内镜下乳头括约肌切开术(EST)术后远期并发症的危险因素。方法回顾分析2008年7月-2013年6月在深圳大学第一附属医院消化内科行EST的患者随访资料,探讨EST术后远期并发症发生的危险因素。两组间比较采用χ2检验,采用Kaplan-Meier法分析并发症累积发生率,单因素以及多因素Logistic回归分析远期并发症的危险因素。结果所有患者随访457个月,平均随访(30.9±12.1)个月。EST术后远期并发症累积发生率为9.9%(18/182),包括复发性胆总管结石9例,复发性胆管炎6例,急性胆囊炎2例,胆道狭窄1例;单因素分析显示,胆总管直径、憩室旁乳头、胆道积气组间差异均有统计学意义(P值均<0.05),进一步多因素Logistic回归分析显示,胆总管直径≥15 mm和胆道积气是EST术后远期并发症发生的危险因素[比值比(OR)=4.82,95%可信区间(95%CI):1.0821.55,P=0.040;OR=6.19,95%CI:1.2331.23,P=0.027]。结论良性胆胰疾病E...
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关键词:
- 括约肌切开术,内窥镜 /
- 手术后并发症 /
- 危险因素
Abstract: Objective To investigate the risk factors for long- term complications after endoscopic sphincterotomy( EST) for benign biliary and pancreatic diseases. Methods The follow- up data of the patients who underwent EST in Department of Gastroenterology,The First Affiliated Hospital of Shenzhen University,from July 2008 to June 2013 were analyzed retrospectively,and the risk factors for long- term complications after EST were investigated. The chi- square test was applied for comparision of categorical data betwee groups. The Kaplan-Meier method was applied to analyze the cumulative incidence of complications,and the univariate and multivariate logistic regression analyses were applied to investigate the risk factors for long- term complications. Results The patients were followed up for 4- 57 months,and the mean follow- up time was 30. 9 ± 12. 1 months. The cumulative incidence of long- term complications after EST was 9. 9%( 18 /182),and these complications included recurrent common bile duct stones( n = 9),recurrent cholangitis( n = 6),acute cholecystitis( n = 2),and biliary stricture( n = 1). There were significant differences between the two groups in diameter of common biledute,pneumobilia,and juxtapapillary diverticulum( all P < 0. 05). The multivariate logistic regression analysis showed that diameter of common bile duct ≥15 mm( OR = 4. 82,95% CI: 1. 08- 21. 55,P = 0. 040) and pneumobilia( OR = 6. 19,95% CI: 1. 23- 31. 23,P = 0. 027) were the risk factors for long- term complications after EST. Conclusion The incidence of long- term complications after EST for benign biliary and pancreatic diseases is low,and diameter of common bile duct ≥15 mm and pneumobilia are the risk factors for long- term complications after EST.-
Key words:
- sphincterotomy,endoscopic /
- postoperative complications /
- risk factors
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