Risk factors for recurrence of common bile duct stones after endoscopic retrograde cholangiopancreatography
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摘要: 目的探讨经内镜逆行胰胆管造影(ERCP)取石后复发患者的临床特点及危险因素。方法回顾性分析2013年1月-2015年6月就诊于青海省人民医院并行ERCP取石治疗的胆总管结石患者的临床资料。共入组292例,根据有无胆总管结石复发分为复发组31例和未复发组261例,比较2组患者的年龄、性别、BMI、胆道情况和胆石情况等临床资料。计数资料组间比较采用χ2检验,筛选出的因素进行二元logistic回归分析。结果复发组和未复发组在结石数量≥2个和胆管直径≥14 mm两个方面差异均有统计学意义(χ2值分别为4.80、5.61,P值均<0.05),而既往有胆囊切除史是胆总管结石复发的独立危险因素(比值比=20.10,95%可信区间:4.1198.25,P<0.05)。结论既往有胆囊切除史是导致ERCP取石后胆总管结石复发的重要危险因素。
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关键词:
- 胆总管结石 /
- 复发 /
- 胰胆管造影术,内窥镜逆行 /
- 危险因素
Abstract: Objective To investigate the clinical features of patients with recurrence after endoscopic retrograde cholangiopancreatography( ERCP) and cholecystolithotomy and related risk factors.Methods A retrospective analysis was performed for the clinical data of patients with common bile duct stones who visited our hospital from January 2013 to June 2015 and underwent ERCP and cholecystolithotomy.A total of 292 patients were enrolled,and according to the presence or absence of recurrence of common bile duct stones,these patients were divided into recurrence group with 31 patients and non- recurrence group with 261 patients.The clinical data including age,sex,body mass index( BMI),and the conditions of the biliary tract and bile duct stones were compared between the two groups.The chi- square test was used for comparison of categorical data between groups,and the binary logistic regression was used for the analysis of factors that were screened out.Results There were significant differences in the proportions of patients with a number of stones ≥2 or bile duct diameter ≥14 mm between the two groups( χ~2= 4.80 and 5.61,both P < 0.05).A previous history of cholecystectomy was an independent risk factor for the recurrence of common bile duct stones( OR = 20.10,95% CI:4.11- 98.25,P < 0.05).Conclusion A previous history of cholecystectomy increases the risk of recurrence of common bile duct stones after ERCP.-
Key words:
- choledocholithiasis /
- recurrence /
- cholangiopancreatography /
- endoscopic retrograde
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