施惠海　周春晓　杨柳　张金坤

[摘要] 目的 研究胆总管结石经ERCP取石术后复发的相关危险因素。 方法 方便收集该院2009年9月—2014年9月期间进行ERCP胆总管取石患者的相关资料，包括性别、年龄、胆囊切除术、胆总管多发结石、胆总管直径，对其进行回顾性分析。采用χ2检验筛选出胆总管结石ERCP术后复发的相关危险因素，后采用多因素Logistic回归统计分析胆总管结石ERCP术后复发的独立危险因素。 结果 共纳入276例患者，有23例复发，复发率8.3%。 提示胆囊切除术后、多发结石与结石复发相关。Logistic回归分析提示胆囊切除术后为结石复发的独立危险因素。 结论 胆囊切除术后为胆总管结石ERCP术后复发的独立危险因素。

[关键词] 逆行胰胆管造影术;胆总管结石;回顾性研究;危险因素

[中图分类号] R4674          [文献标识码] A          [文章编号] 1674-0742（2019）05（a）-0073-04

[Abstract] Objective To investigate the risk factors for recurrence of common bile duct stones after treatment with ERCP. Methods Data of patients with ERCP choledocholithotomy from September 2009 to September 2014 were convenient collected， including gender， age， cholecystectomy， common bile duct stones and common bile duct diameter. χ2 test was used to select the related risk factors of postoperative recurrence of common bile duct calculi ERCP， and multivariate Logistic regression was used to analyze the independent risk factors of postoperative recurrence of common bile duct calculi ERCP. Results A total of 276 patients were included， and 23 of them had recurrence， and the recurrence rate was 8.3%. Logistic regression analysis suggested that cholecystectomy was an independent risk factor for stone recurrence. Conclusion Cholecystectomy is an independent risk factor for the recurrence of CBD stones.

[Key words] Retrograde cholangiopancreatography; Common bile duct stones; Retrospective study; Risk factors

经内镜逆行胰胆管造影术（ERCP）诞生于20世纪60年代末，内镜下Vater乳头的插管初次报道于19世纪60年代。经过50余年的不断发展完善，现已成为融诊断、治疗于一提的完整的学科体系，在胆胰疾病临床诊疗中发挥着极其重要的作用，目前已成为治疗胆总管结石的主要手段，内镜下十二指肠球囊扩张术（EPBD）及乳头切开术（ ES）已广泛应用于临床。大量研究显示，ERCP术后胆总管结石存在复发，ERCP取石术后存在一定复发率[1]，增加了患者及社会的经济负担。该研究对该院2009年9月—2014年9月期间共276例经胆总管内镜取石患者的病例资料进行分析，了解胆总管结石ERCP治疗后的复发率，并分析复发的危险因素，现报道如下。……