Lujian Peng, Xianneng Cheng, Lei Zhang
Department of General Surgery, Traditional Chinese Medicine Hospital, Chongqing, China.
Medicine (Baltimore). 2020 Jul 2;99(27):e20412. doi: 10.1097/MD.0000000000020412.
To explore the risk factors related to the recurrence of common bile duct stones (CBDS) after endoscopic retrograde cholangiopancreatography (ERCP), so as to provide reference for reducing the recurrence of CBDS after ERCP.The clinical data of 385 patients with CBDS treated by ERCP from March 2012 to May 2016 were collected. According to the diagnostic criteria of recurrence of CBDS, the patients were divided into recurrence group and control group. The general information of the patients, personal history, past history, and surgical-related information were collected. Univariate analysis and multivariate logistic regression analysis were performed on the collected data to identify risk factors for recurrence of CBDS after ERCP.A total of 262 patients were included in the study, of which 51 had recurrence of CBDS, with a recurrence rate of 19.46%. Multivariate Logistic analysis () showed greasy diet (P = .436), history of cholecystectomy (P = .639) and gallstone size (P = .809) were not independent risk factor for recurrence of stones after ERCP in CBDS. But age ≥65 (P = .013), history of common bile duct incision (P = .001), periampullary diverticulum (P = .001), common bile duct diameter ≥1.5 cm (P = .024), ERCP ≥2 (P = .003), the number of stones ≥2 (P = .015), the common bile duct angle ≤120° (P = .002) and the placement of bile duct stent (P = .004) are important independent risk factor for recurrence of stones after ERCP in CBDS.This study confirmed that ag ≥65, history of choledochotomy, periampullary diverticulum, diameter of common bile duct (≥15 mm), multiple ERCP, the number of stones ≥2, stent placement and angle of common bile duct < 120° were independent risk factors for recurrence of CBDS after ERCP.
探讨内镜逆行胰胆管造影术（ERCP）后胆总管结石（CBDS）复发的相关危险因素，为降低ERCP术后CBDS复发提供参考。收集2012年3月至2016年5月期间385例行ERCP治疗的CBDS患者的临床资料。根据CBDS复发的诊断标准，将患者分为复发组和对照组。收集患者的一般资料、个人史、既往史及手术相关信息。对收集的数据进行单因素分析和多因素logistic回归分析，以确定ERCP术后CBDS复发的危险因素。本研究共纳入262例患者，其中51例出现CBDS复发，复发率为19.46%。多因素Logistic分析（）显示，油腻饮食（P = 0.436）、胆囊切除术史（P = 0.639）和结石大小（P = 0.809）不是CBDS患者ERCP术后结石复发的独立危险因素。但年龄≥65岁（P = 0.013）、胆总管切开史（P = 0.001）、壶腹周围憩室（P = 0.001）、胆总管直径≥1.5 cm（P = 0.024）、ERCP次数≥2次（P = 0.003）、结石数量≥2个（P = 0.015）、胆总管夹角≤120°（P = 0.002）及胆管支架置入（P = 0.004）是CBDS患者ERCP术后结石复发的重要独立危险因素。本研究证实，年龄≥65岁、胆总管切开史、壶腹周围憩室、胆总管直径（≥15 mm）、多次ERCP、结石数量≥2个、支架置入及胆总管夹角<120°是ERCP术后CBDS复发的独立危险因素。
