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胆总管取石术后结石复发危险因素的研究进展

李积强 张桂信

引用本文:
Citation:

胆总管取石术后结石复发危险因素的研究进展

DOI: 10.3969/j.issn.1001-5256.2023.01.036
基金项目: 

国家自然科学资金 (82174136);

辽宁省卫健委中医药临床重点专科能力建设项目(辽卫办 2019[169]) ( )

利益冲突声明:所有作者均声明不存在利益冲突。
作者贡献声明:李积强负责查阅和收集相关文献及撰写论文;张桂信负责拟定写作思路、指导撰写文章并最终定稿。
详细信息
    通信作者:

    张桂信,zgx0109@126.com (ORCID: 0000-0002-6171-394X)

Research advances in the risk factors for recurrence of common bile duct stone after choledocholithotomy

Research funding: 

National Natural Science Foundation of China (82174136);

Capacity building Project of Key Clinical Specialty of Traditional Chinese Medicine of Liaoning Provincial Health Commission(Liaoning Health Office 2019(169)) ( )

More Information
    Corresponding author: ZHANG Guixin, zgx0109@126.com (ORCID: 0000-0002-6171-394X)
  • 摘要: 胆石症是消化系统的常见病及多发病且随着生活水平改善发病率呈上升趋势,其中5%~15%的患者患有胆囊结石合并有胆总管结石。胆总管结石可引起急性胆管炎、胆源性胰腺炎等一系列严重的并发症。胆总管取石术是治疗胆总管结石的主要方法,但其术后仍存在较高的复发率。胆总管结石的复发严重影响患者生活并且加重患者的经济负担。本文通过查阅最新发表的相关临床研究,归纳了解剖学、结石相关、胆道及手术相关等多方面影响胆总管结石复发的因素,为胆总管结石治疗及预防结石复发提供参考。

     

  • [1] CIANCI P, RESTINI E. Management of cholelithiasis with choledocholithiasis: Endoscopic and surgical approaches[J]. World J Gastroenterol, 2021, 27(28): 4536-4554. DOI: 10.3748/wjg.v27.i28.4536.
    [2] LI ZQ, SUN JX, LI B, et al. Meta-analysis of single-stage versus two-staged management for concomitant gallstones and common bile duct stones[J]. J Minim Access Surg, 2020, 16(3): 206-214. DOI: 10.4103/jmas.JMAS_146_18.
    [3] WU Y, XU CJ, XU SF. Advances in risk factors for recurrence of common bile duct stones[J]. Int J Med Sci, 2021, 18(4): 1067-1074. DOI: 10.7150/ijms.52974.
    [4] WANG LM, CHEN C, DING H, et al. Analysis of risk factors for recurrence of cholecystolithiasis after retrograde cholecystectomy with laparoscopic cholecystectomy[J/CD]. Chin Arch Gen Surg(Electronic Edition), 2019, 13(3): 224-228. DOI: 10.3877/cma.j.issn.1674-0793.2019.03.012.

    王雷鸣, 陈晨, 丁辉, 等. 经内镜逆行胰胆管造影联合腹腔镜胆囊切除术后胆囊结石合并胆总管结石复发的危险因素分析[J/CD]. 中华普通外科学文献(电子版), 2019, 13(3): 224-228. DOI: 10.3877/cma.j.issn.1674-0793.2019.03.012.
    [5] RYU S, JO IH, KIM S, et al. Clinical impact of common bile duct angulation on the recurrence of common bile duct stone: a meta-analysis and review[J]. Korean J Gastroenterol, 2020, 76(4): 199-205. DOI: 10.4166/kjg.2020.76.4.199.
    [6] KEIZMAN D, SHALOM MI, KONIKOFF FM. An angulated common bile duct predisposes to recurrent symptomatic bile duct stones after endoscopic stone extraction[J]. Surg Endosc, 2006, 20(10): 1594-1599. DOI: 10.1007/s00464-005-0656-x.
    [7] CHONG CC, CHIU PW, TAN T, et al. Correlation of CBD/CHD angulation with recurrent cholangitis in patients treated with ERCP[J]. Endosc Int Open, 2016, 4(1): E62-E67. DOI: 10.1055/s-0035-1569689.
    [8] JANSSEN BV, van LAARHOVEN S, ELSHAER M, et al. Comprehensive classification of anatomical variants of the main biliary ducts[J]. Br J Surg, 2021, 108(5): 458-462. DOI: 10.1093/bjs/znaa147.
    [9] CHOI SJ, YOON JH, KOH DH, et al. Low insertion of cystic duct increases risk for common bile duct stone recurrence[J]. Surg Endosc, 2022, 36(5): 2786-2792. DOI: 10.1007/s00464-021-08563-2.
    [10] TSITOURIDIS I, LAZARAKI G, PAPASTERGIOU C, et al. Low conjunction of the cystic duct with the common bile duct: does it correlate with the formation of common bile duct stones?[J]. Surg Endosc, 2007, 21(1): 48-52. DOI: 10.1007/s00464-005-0498-6.
    [11] LU ZH, NIU J, XU PP, et al. Analysis of related risk factors for recurrence of choledocholithiasis after the operation[J]. Chin J Curr Adv Gen Surg, 2016, 19(5): 372-375. DOI: 10.3969/j.issn.1009-9905.2016.05.011.

    鲁志华, 牛军, 许平平, 等. 胆总管取石并胆囊切除术后胆总管结石复发的相关危险因素分析[J]. 中国现代普通外科进展, 2016, 19(5): 372-375. DOI: 10.3969/j.issn.1009-9905.2016.05.011.
    [12] CAO J, LI TY, ZHOU J, et al. The effect of periampullary diverticulum on the stone composition and biliary flora in patients with choledocholithiasis[J]. Chin J Microecol, 2022, 34(3): 300-305. DOI: 10.13381/j.cnki.cjm.202203010.

    曹洁, 李天亚, 周静, 等. 壶腹周围憩室对胆总管结石患者结石成分及胆道菌群的影响[J]. 中国微生态学杂志, 2022, 34(3): 300-305. DOI: 10.13381/j.cnki.cjm.202203010.
    [13] SANDSTAD O, OSNES T, SKAR V, et al. Structure and composition of common bile duct stones in relation to duodenal diverticula, gastric resection, cholecystectomy and infection[J]. Digestion, 2000, 61(3): 181-188. DOI: 10.1159/000007755.
    [14] WANG Y, JIE J, QIAN B, et al. Analysis of the relationship between periampullary diverticulum and recurrent bile duct stones after endoscopy on magnetic resonance imaging of magnetic nanoparticles[J]. J Biomed Nanotechnol, 2022, 18(2): 607-615. DOI: 10.1166/jbn.2022.3270.
    [15] YOO ES, YOO BM, KIM JH, et al. Evaluation of risk factors for recurrent primary common bile duct stone in patients with cholecystectomy[J]. Scand J Gastroenterol, 2018, 53(4): 466-470. DOI: 10.1080/00365521.2018.1438507.
    [16] WU RZ. Analysis of related factors of recurrent choledocholithiasis after cholecystectomy and choledocholithiasis[J]. Chin Foreign Med Res, 2017, 15(5): 45-47. DOI: 10.14033 / j.carol carroll nki CFMR. 2017.5.024.

    吴润芝. 胆总管取石并胆囊切除术后胆总管结石复发的相关因素分析[J]. 中外医学研究, 2017, 15(5): 45-47. DOI: 10.14033/j.cnki.cfmr.2017.5.024.
    [17] MENG H. Risk factors for recurrent choledocholithiasis after ERCP lithotomy[J]. Hebei Med J, 2016, 38(5): 716-718. DOI: 10.3969/j.issn.1002-7386.2016.05.025.

    孟环. ERCP取石后胆总管结石复发的相关危险因素研究[J]. 河北医药, 2016, 38(5): 716-718. DOI: 10.3969/j.issn.1002-7386.2016.05.025.
    [18] LUJIAN P, XIANNENG C, LEI Z. Risk factors of stone recurrence after endoscopic retrograde cholangiopancreatography for common bile duct stones[J]. Medicine (Baltimore), 2020, 99(27): e20412. DOI: 10.1097/MD.0000000000020412.
    [19] PARK SY, HONG TH, LEE SK, et al. Recurrence of common bile duct stones following laparoscopic common bile duct exploration: a multicenter study[J]. J Hepatobiliary Pancreat Sci, 2019, 26(12): 578-582. DOI: 10.1002/jhbp.675.
    [20] QUARESIM S, BAlla A, GUERRIERI M et al. Results of medium seventeen years' follow-up after laparoscopic choledochotomy for ductal stones. [J]. Gastroenterol Res Pract, 2016, 2016: 9506406. DOI: 10.1155/2016/9506406
    [21] CUI ML, CHO JH, KIM TN. Long-term follow-up study of gallbladder in situ after endoscopic common duct stone removal in Korean patients. [J]. Surg Endosc, 2013, 27: 1711-6. DOI: 10.1007/s00464-012-2662-0
    [22] THISTLE JL. Pathophysiology of bile duct stones[J]. World J Surg, 1998, 22(11): 1114-1118. DOI: 10.1007/s002689900529.
    [23] KUNDUMADAM S, FOGEL EL, GROMSKI MA. Gallstone pancreatitis: general clinical approach and the role of endoscopic retrograde cholangiopancreatography[J]. Korean J Intern Med, 2021, 36(1): 25-31. DOI: 10.3904/kjim.2020.537.
    [24] CAI Y, HE YA. Risk factors for recurrence of stones after LC combined LCHTD in patients with gallbladder and common bile duct stones[J]. J Hepatobiliary Surg, 2016, 24 (3): 203-205. https://www.cnki.com.cn/Article/CJFDTOTAL-GDWZ201603015.htm

    蔡宇, 何彦安. 胆囊结石合并胆总管结石患者行腹腔镜胆囊切除联合胆总管切开取石T管引流术后结石复发危险因素分析[J]. 肝胆外科杂志, 2016, 24(3): 203-205. https://www.cnki.com.cn/Article/CJFDTOTAL-GDWZ201603015.htm
    [25] NIJIATIJIANG A, ALIMUJIANG A, ALIDAN A, et al. Efficacy of LC combined with LCHTD in treatment of choledocholithiasis complicated with cholecystolithiasis and the related factors of postoperative recurrence of choledocholithiasis[J]. J Hepatobiliary Surg, 2021, 33(7): 419-422. DOI: 10.11952/j.issn.1007-1954.2021.07.007.

    尼加提江·艾比不拉, 阿力木江·阿布力米提, 阿里旦·艾尔肯, 等. LC联合LCHTD治疗胆总管结石合并胆囊结石的效果及术后胆总管结石复发的相关因素分析[J]. 肝胆胰外科杂志, 2021, 33(7): 419-422. DOI: 10.11952/j.issn.1007-1954.2021.07.007.
    [26] LYU YH, ZHANG HC, SONG CY, et al. Logistic regression analysis of related factors of stone recurrence after laparoscopic cholecystectomy combined with choledocholithotomy and T-tube drainage[J]. Chongqing Med, 2016, 45(9): 1262-1264. DOI: 10.3969/j.issn.1671-8348.2016.09.033.

    吕运海, 张焕常, 宋朝阳, 等. 腹腔镜胆囊切除联合胆总管切开取石T管引流术后结石复发相关因素的Logistic回归分析[J]. 重庆医学, 2016, 45(9): 1262-1264. DOI: 10.3969/j.issn.1671-8348.2016.09.033.
    [27] QIU WG, XU J. Analysis of risk factors for postoperative recurrence of gallbladder stones with common bile duct stones[J]. Chin J Gen Surg, 2014, 23 (2): 170-173. DOI: 10.7659/j.issn.1005-6947.2014.02.006.

    裘文刚, 徐江. 胆囊结石合并胆总管结石术后复发的危险因素分析[J]. 中国普通外科杂志, 2014, 23(2): 170-173. DOI: 10.7659/j.issn.1005-6947.2014.02.006.
    [28] XU L, SUN WR, LI Y. Laparoscopic cholecystectomy combined with choledocholithot- omy and T-tube drainage for treatment of choledocholithiasis combined with cho-ledocholithiasis and its influencing factors[J]. J Clin Psychosom Dis, 2021, 27(2): 156-159. DOI: 10.3969/j.issn.1672-187X.2021.02.036.

    徐璐, 孙万日, 黎洋. 腹腔镜胆囊切除联合胆总管切开取石T管引流术治疗胆囊结石合并胆总管结石术后复发率及影响因素[J]. 临床心身疾病杂志, 2021, 27(2): 156-159. DOI: 10.3969/j.issn.1672-187X.2021.02.036.
    [29] AL-HABBAL Y, REID I, TIANG T, et al. Retrospective comparative analysis of choledochoscopic bile duct exploration versus ERCP for bile duct stones[J]. Sci Rep, 2020, 10(1): 14736. DOI: 10.1038/s41598-020-71731-2.
    [30] ZHANG Q, YE M, SU W, et al. Sphincter of Oddi laxity alters bile duct microbiota and contributes to the recurrence of choledocholithiasis[J]. Ann Transl Med, 2020, 8(21): 1383. DOI: 10.21037/atm-20-3295.
    [31] GUPTA N. Role of laparoscopic common bile duct exploration in the management of choledocholithiasis[J]. World J Gastrointest Surg, 2016, 8(5): 376-381. DOI: 10.4240/wjgs.v8.i5.376.
    [32] TAKIMOTO Y, IRISAWA A, HOSHI K, et al. The impact of endoscopic sphincterotomy incision size on common bile duct stone recurrence: A propensity score matching analysis[J]. J Hepatobiliary Pancreat Sci, 2021. DOI: 10.1002/jhbp.1083.[Online ahead of print]
    [33] HUANG B, CHEN YF, ZHAI M, et al. Comparison of the efficacy of primary suture and T-tube drainage in patients with choledocholithiasis and analysis of influencing factors for postoperative recurrence[J]. Chin J Med, 2021, 56(9): 980-984. DOI: 10.3969/j.issn.1008-1070.2021.09.016.

    黄博, 陈一帆, 翟敏, 等. 胆总管结石术后一期缝合与T管引流的疗效对比及复发因素分析[J]. 中国医刊, 2021, 56(9): 980-984. DOI: 10.3969/j.issn.1008-1070.2021.09.016.
    [34] WANG X, WANG X, SUN H, et al. Endoscopic papillary large balloon dilation reduces further recurrence in patients with recurrent common bile duct stones: a randomized controlled trial[J]. Am J Gastroenterol, 2022, 117(5): 740-747. DOI: 10.14309/ajg.0000000000001690.
    [35] PARK BK, SEO JH, JEON HH, 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. DOI: 10.1007/s00535-017-1419-x.
    [36] LEE SJ, CHOI IS, MOON JI, et al. Optimal treatment for concomitant gallbladder stones with common bile duct stones and predictors for recurrence of common bile duct stones[J]. Surg Endosc, 2022, 36(7): 4748-4756. DOI: 10.1007/s00464-021-08815-1.
    [37] LAN T, CUI NQ. Analysis of risk factors for postoperative recurrence of common bile duct stones[J]. Chin J Surg Integr Tradit West Med, 2016, 22 (6): 538-541. DOI: 10.3969/j.issn.1007-6948.2016.06.005.

    兰涛, 崔乃强. 胆总管结石术后复发危险因素的分析[J]. 中国中西医结合外科杂志, 2016, 22(6): 538-541. DOI: 10.3969/j.issn.1007-6948.2016.06.005.
    [38] ZHU WG, ZHENG XP. Analysis of risk factors related to postoperative recurrence of common bile duct stones[J]. J Qiqihar Med Coll, 2016, 37 (16): 2050-2052. https://www.cnki.com.cn/Article/CJFDTOTAL-QQHB201616018.htm

    朱卫国, 郑小平. 胆总管结石术后复发的相关危险因素分析[J]. 齐齐哈尔医学院学报, 2016, 37(16): 2050-2052. https://www.cnki.com.cn/Article/CJFDTOTAL-QQHB201616018.htm
    [39] FEI J, HAN TQ, JIANG ZY, et al. Primary study on inheritant characteristics in cholelithiasis pedigrees[J]. J Hepatobiliary Surg, 2002, 14(1): 4-6. DOI: 10.3969/j.issn.1007-1954.2002.01.003.

    费健, 韩天权, 蒋兆彦, 等. 胆囊结石病家系遗传特征的初步研究[J]. 肝胆胰外科杂志, 2002, 14(1): 4-6. DOI: 10.3969/j.issn.1007-1954.2002.01.003.
    [40] von SCHÖNFELS W, BUCH S, WÖLK M, et al. Recurrence of gallstones after cholecystectomy is associated with ABCG5/8 genotype[J]. J Gastroenterol, 2013, 48(3): 391-396. DOI: 10.1007/s00535-012-0639-3.
    [41] ZHAO HD, GAO P, ZHAN L. The mechanism of intestinal flora and its metabolites in the formation of cholesterol gallstones[J]. J Clin Hepatol, 2022, 38(4): 947-950. DOI: 10.3969/j.issn.1001-5256.2022.04.042.

    赵瀚东, 高鹏, 詹丽. 肠道菌群及其代谢物在胆囊胆固醇结石形成中的作用机制[J]. 临床肝胆病杂志, 2022, 38(4): 947-950. DOI: 10.3969/j.issn.1001-5256.2022.04.042.
    [42] ZHANG Z, XIAO HL, ZHAO YH. Gallstone composition and lipid metabolism can influence the recurrence of common bile duct calculi after ERCP[J]. Chin J Health Care Med, 2021, 23(6): 615-618. DOI: 10.3969/j.issn.1674-3245.2021.06.016.

    张芝, 肖红利, 赵云华. 胆石成分和脂质代谢指标对胆总管结石ERCP术后结石复发的影响[J]. 中华保健医学杂志, 2021, 23(6): 615-618. DOI: 10.3969/j.issn.1674-3245.2021.06.016.
    [43] LIU QX, HAN W, LI T, et al. Clinical analysis of laparoscopic cholecystectomy combined with choledochoscopy in the treatment of recurrent choledocholithiasis[J]. Mod Med, 2017, 45 (9): 1333-1337. DOI: 10.3969/j.issn.1671-7562.2017.09.026.

    刘全新, 韩威, 李涛, 等. 腹腔镜联合胆道镜治疗胆总管结石复发预后的临床分析[J]. 现代医学, 2017, 45(9): 1333-1337. DOI: 10.3969/j.issn.1671-7562.2017.09.026.
    [44] FUKUBA N, ISHIHARA S, SONOYAMA H, et al. Proton pump inhibitor is a risk factor for recurrence of common bile duct stones after endoscopic sphincterotomy - propensity score matching analysis[J]. Endosc Int Open, 2017, 5(4): E291-E296. DOI: 10.1055/s-0043-102936.
    [45] SBEIT W, ABUKAES H, SAID AHMAD H, et al. The possible association of proton pump inhibitor use with acute cholangitis in patients with choledocholithiasis: a multi-center study[J]. Scand J Gastroenterol, 2022 : 1-5. DOI: 10.1080/00365521.2022.2106150.
    [46] RYUICHI Y, TAZUMA S, KANNO K et al. Ursodeoxycholic acid after bile duct stone removal and risk factors for recurrence: a randomized trial. [J]. J Hepatobiliary Pancreat Sci, 2016, 23(2): 132-136. DOI: 10.1002/jhbp.316.
    [47] CHEN X, YAN XR, ZHANG LP. Ursodeoxycholic acid after common bile duct stones removal for prevention of recurrence: A systematic review and meta-analysis of randomized controlled trials[J]. Medicine (Baltimore), 2018, 97(45): e13086. DOI: 10.1097/MD.0000000000013086.
    [48] ENDO R, SATOH A, TANAKA Y, et al. Saline solution irrigation of the bile duct after stone removal reduces the recurrence of common bile duct stones[J]. Tohoku J Exp Med, 2020, 250(3): 173-179. DOI: 10.1620/tjem.250.173.
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