Wu Ying-Jie
Department of Hepatobiliary Pancreatic Surgery, The First Affiliated Hospital of Ningbo University, Ningbo 315000, Zhejiang Province, China.
World J Gastrointest Surg. 2024 Sep 27;16(9):2823-2828. doi: 10.4240/wjgs.v16.i9.2823.
Choledocholithiasis is a common clinical bile duct disease, laparoscopic choledocholithotomy is the main clinical treatment method for choledocholithiasis. However, the recurrence of postoperative stones is a big challenge for patients and doctors.
To explore the related risk factors of gallstone recurrence after laparoscopic choledocholithotomy, establish and evaluate a clinical prediction model.
A total of 254 patients who underwent laparoscopic choledocholithotomy in the First Affiliated Hospital of Ningbo University from December 2017 to December 2020 were selected as the research subjects. Clinical data of the patients were collected, and the recurrence of gallstones was recorded based on the postoperative follow-up. The results were analyzed and a clinical prediction model was established.
Postoperative stone recurrence rate was 10.23% (26 patients). Multivariate Logistic regression analysis showed that cholangitis, the diameter of the common bile duct, the diameter of the stone, number of stones, lithotripsy, preoperative total bilirubin, and T tube were risk factors associated with postoperative recurrence ( < 0.05). The clinical prediction model was ln (p/1-p) = -6.853 + 1.347 × cholangitis + 1.535 × choledochal diameter + 2.176 × stone diameter + 1.784 × stone number + 2.242 × lithotripsy + 0.021 × preoperative total bilirubin + 2.185 × T tube.
Cholangitis, the diameter of the common bile duct, the diameter of the stone, number of stones, lithotripsy, preoperative total bilirubin, and T tube are the associated risk factors for postoperative recurrence of gallstone. The prediction model in this study has a good prediction effect, which has a certain reference value for recurrence of gallstone after laparoscopic choledocholithotomy.
胆总管结石是一种常见的临床胆管疾病，腹腔镜胆总管切开取石术是胆总管结石的主要临床治疗方法。然而，术后结石复发对患者和医生来说都是一个巨大的挑战。
探讨腹腔镜胆总管切开取石术后胆石复发的相关危险因素，建立并评估临床预测模型。
选取2017年12月至2020年12月在宁波大学第一附属医院行腹腔镜胆总管切开取石术的254例患者作为研究对象。收集患者的临床资料，并根据术后随访记录胆石复发情况。对结果进行分析并建立临床预测模型。
术后结石复发率为10.23%（26例患者）。多因素Logistic回归分析显示，胆管炎、胆总管直径、结石直径、结石数量、碎石术、术前总胆红素及T管是与术后复发相关的危险因素（<0.05）。临床预测模型为ln（p/1-p）=-6.853+1.347×胆管炎+1.535×胆总管直径+2.176×结石直径+1.784×结石数量+2.242×碎石术+0.021×术前总胆红素+2.185×T管。
胆管炎、胆总管直径、结石直径、结石数量、碎石术、术前总胆红素及T管是胆石术后复发的相关危险因素。本研究中的预测模型具有良好的预测效果，对腹腔镜胆总管切开取石术后胆石复发具有一定的参考价值。
