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胆囊切除术后症状性胆总管结石复发的危险因素。

Risk factors for recurrence of symptomatic common bile duct stones after cholecystectomy.

机构信息

Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Ji-dong, Paldal-gu, Gyeonggi-do, Suwon 442-723, Republic of Korea.

出版信息

Gastroenterol Res Pract. 2012;2012:417821. doi: 10.1155/2012/417821. Epub 2012 Sep 6.

Abstract

Purpose. The recurrence of CBD stone is still observed in a considerable number of patients. The study was to evaluate the risk factors for recurrence of symptomatic CBD stone in patients who underwent cholecystectomy after the removal of CBD stone. Methods. The medical records of patients who underwent removal of CBD stone with subsequent cholecystectomy were reviewed. The risk factors for the recurrence of symptomatic CBD stone were compared between the recurrence and the nonrecurrence group. Results. The mean follow-up period was 40.6 months. The recurrence of symptomatic CBD stones was defined as the detection of bile duct stones no sooner than 6 months after complete clearance of CBD stones, based on symptoms or signs of biliary complication. 144 patients (68 males, 47.2%) were finally enrolled and their mean age was 59.8 (range: 26~86) years. The recurrence of CBD stone occurred in 15 patients (10.4%). The mean period until first recurrence was 25.9 months. The presence of type 1 or 2 periampullary diverticulum and multiple CBD stones were the independent risk factors. Conclusion. For the patients with type 1 or 2 periampullary diverticulum or multiple CBD stones, careful followup is needed for the risk in recurrence of symptomatic CBD stone.

摘要

目的

胆总管结石(CBD)取石术后患者仍有相当数量出现结石复发。本研究旨在评估 CBD 取石术后行胆囊切除术患者发生有症状 CBD 结石复发的相关危险因素。

方法

回顾性分析行 CBD 取石联合胆囊切除术患者的临床资料,比较有症状 CBD 结石复发组与无复发组的危险因素。

结果

144 例患者(男 68 例,47.2%)纳入本研究,平均随访时间为 40.6 个月。复发定义为在 CBD 结石完全清除后 6 个月内出现胆管结石,以胆道并发症的症状或体征为依据。15 例(10.4%)患者出现 CBD 结石复发,首次复发的平均时间为 25.9 个月。存在胰胆管合流异常和多发 CBD 结石是 CBD 结石复发的独立危险因素。

结论

对于存在胰胆管合流异常或多发 CBD 结石的患者,需要密切随访,警惕有症状 CBD 结石复发的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a5b/3443611/1e9ccf529d08/GRP2012-417821.001.jpg

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