摘要
目的:总结胰十二指肠切除术后胆管炎(CFPD)的诊断和治疗,分析其发生的危险因素.方法:回顾性分析2004-01/2007-08胰十二指肠切除术(PD)99例,其中CFPD患者26例,单因素分析CFPD发生的相关的因素,将有统计学意义的变量再引入非条件Logistic回归模型进行多因素分析.结果:CFPD发生率为26.3%(26/99),肝内胆管置管持续低压冲洗、调整抗生素、加用利胆药物可有效控制胆管炎.多因素Logistic回归分析表明,术前胆总管直径,术后输入袢梗阻及术前减黄对于CFPD的发生具有统计学意义(OR=0.241,10.335,0.102,均P<0.05),CFPD与PD术后无并发症病例相比术后住院时间延长,具有统计学意义(Z=-2.947,P<0.05).结论:术前胆总管直径≤1.5cm,术后输入袢梗阻为CFPD发生的独立危险因素,术前减黄可减少CFPD的发生,CFPD较PD术后无并发症者术后住院时间明显延长.
AIM： To summarize the diagnosis and treatment for cholangitis following pancreaticoduodenectomy （CFPD） and analyze the related risk factors. METHODS： The clinical data of 99 cases who underwent pancreaticoduodenectomy （PD） from January 2004 to August 2007 were retrospectively analyzed and 26 of them experienced CFPD. Single-factor analysis was performed on the related risk factors, and the statistic significant difference was re-introduced by nononditional logistic regression model for multivariate analysis. RESULTS： The occurrence of CFPD was 26.3% （26/99）. Cholangitis was well managed with the treatment of putting catheter in intrahepatic bile duct for continuous low-pressure perfusion and administration of antibiotics and cholagogic drugs. Multi-factor logistic regression analysis showed that there were significant differences in preoperative bile duct diameter, postoperative input loop obstruction and preoperative bfliary drainage in CFPD （OR = 0.241, 10.335, 0.102, all P 〈 0.05）. In comparison with PD patients without complications, the duration of hospitaliza- tion for the CFPD patients also showed statisti- cally significant difference （Z =-2.947, P 〈 0.05）. CONCLUSION： The bile duct diameter less than 1.5 cm before operation and postoperative input loop obstruction are the independent risk factors for CFPD occurrence. The preoperative biliary drainage could reduce CFPD occurrence. In comparison with PD patients without complication, the duration of hospitalization for the CFPD patients is remarkably prolonged.
出处
《世界华人消化杂志》
CAS
北大核心
2009年第14期1477-1480,共4页
World Chinese Journal of Digestology
关键词
胰十二指肠切除术
胆管炎
减黄
输入袢梗阻
Pancreaticoduodenectomy
Cholangitis
Biliary drainage
Input loop obstruction
