Risk factors for short- term residual common bile duct stones after laparoscopic cholecystectomy

Objective To investigate the risk factors for short- term residual common bile duct stones after laparoscopic cholecystectomy( LC),and to provide a reference for clinical prevention and treatment.Methods A total of 18 patients with short- term residual common bile duct stones after LC who were admitted to The First Affiliated Hospital of Nanyang Medical College from January 2014 to January 2016 were enrolled as observation group,and 320 patients without short- term residual common bile duct stones after LC who were admitted during the same period of time were enrolled as control group.The two groups were compared in terms of acute pancreatitis,alanine aminotransferase( ALT),aspartate aminotransferase( AST),emergency surgery,results of preoperative magnetic resonance cholangiopancreatography( MRCP),direct bilirubin( DBil),the gallbladder full of stones,number of gallstones,minimum stone diameter,gallbladder volume,cystic duct diameter,cystic duct length,and sand- like stones.The independent- samples t test was used for comparison of continuous data between groups,the chi- square test was used for comparison of categorical data between groups,and a logistic multivariate regression analysis was performed for variables with statistical significance.Results The univariate analysis showed that acute pancreatitis,emergency surgery,sand- like stones,retrograde cholecystectomy,preoperative MRCP,number of gallstones,minimum stone diameter,gallbladder volume,cystic duct diameter,and common bile duct diameter were associated with short- term residual common bile duct stones after LC( χ~2=9.801,16.217,5.802,9.865,and 5.145,t = 18.314,6.077,7.687,15.678,and 5.512,all P < 0.05).The multivariate logistic regression analysis showed that acute pancreatitis,retrograde cholecystectomy,common bile duct diameter,and cystic duct diameter were independent risk factors for short- term residual common bile duct stones after LC,while preoperative MRCP was a protective factor.Conclusion Active intervention for risk factors for short- term residual common bile duct stones after LC can reduce the incidence of postoperative residual bile duct stones.