年龄和肥胖是腹腔镜胆囊切除术患者胆管损伤的独立预测因素。
Age and Obesity are Independent Predictors of Bile Duct Injuries in Patients Undergoing Laparoscopic Cholecystectomy.
作者信息
Aziz Hassan, Pandit Viraj, Joseph Bellal, Jie Tun, Ong Evan
机构信息
Division of HepatoPancreaticoBiliary Surgery, University of Arizona, Tucson, AZ, USA,
出版信息
World J Surg. 2015 Jul;39(7):1804-8. doi: 10.1007/s00268-015-3010-z.
INTRODUCTION
Iatrogenic bile duct injury is a serious complication of cholecystectomy. The aim of this study was to assess predictors of bile duct injury using a national database.
METHODS
The Nationwide Inpatient Sample (2010-2012) was queried for laparoscopic cholecystectomy. We used a) diagnoses for bile duct injury and b) bile duct injury repair procedure codes as a surrogate marker for bile duct injuries.
RESULTS
A total of 1,015 patients had bile duct injury. The mean age was 58.2 ± 19.7 years, 53.5 % were males, and median Charlson co-morbidity score was 2 [2, 3]. Multivariate analysis revealed morbid obesity [2.8 (2.1-4.3); p = 0.03] and age >65 [1.5 (1.05-2.1); p = 0.01] as the independent predictors for bile duct injury in patients undergoing cholecystectomy.
CONCLUSION
Our study finds a new association between obesity, aging, and bile duct injuries which has never been reported in literature before.
引言
医源性胆管损伤是胆囊切除术的一种严重并发症。本研究的目的是利用国家数据库评估胆管损伤的预测因素。
方法
查询全国住院患者样本（2010 - 2012年）中的腹腔镜胆囊切除术病例。我们将a）胆管损伤诊断和b）胆管损伤修复手术编码用作胆管损伤的替代标志物。
结果
共有1015例患者发生胆管损伤。平均年龄为58.2±19.7岁，53.5%为男性，Charlson合并症评分中位数为2[2, 3]。多因素分析显示，病态肥胖[2.8（2.1 - 4.3）；p = 0.03]和年龄>65岁[1.5（1.05 - 2.1）；p = 0.01]是胆囊切除患者胆管损伤的独立预测因素。
结论
我们的研究发现肥胖、衰老与胆管损伤之间存在一种此前文献中从未报道过的新关联。
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