Risk factors for developing secondary hepatolithiasis after operations for patients with choledocholithiasis / 中华肝胆外科杂志

ABSTRACT

Objective To study and to analyze the risk factors of developing secondary hepatolithiasis,and the long-term complications of operations for patients with choledocholithiasis (ERCP or Choledocholithotomy).Methods Patients with choledocholithiasis (n =23 764) from the First Affiliated Hospital of Nanchang University treated from January 2012 to December 2016 were studied.The experimental group was the group of choledocholithiasis patients who developed secondary hepatolithiasis.The control group was the group of patients who were randomly selected from the choledocholithiasis patients who did not develop secondary hepatolithiasis.Univariate analysis was performed on the clinical data of the two groups of patients,and multivariate Logistic regression analysis was performed on selected risk factors to finally obtain independent risk factors.Results Univariate analysis found patients in the experimental group was significantly different from patients in the control group in the following clinical data (all P ＜ 0.05):a history of cholecystectomy,biliary stricture,dilated common bile duct (diameter ≥ 15 mm),stone size (≥ 10 mm),increase in high-density lipoprotein cholesterol (≥ 1.29 mmol/L),and increase in postoperative direct bilirubin (≥ 13.68 μmol/L).Multivariate analysis showed that a history of cholecystectomy,biliary stricture,dilated common bile duct,elevated high-density lipoprotein cholesterol,and elevated postoperative direct bilirubin were independent risk factors (all P ＜ 0.05).Conclusions Secondary hepatolithiasis after operations for choledocholithiasis was the result of multiple risk factors.Five independent risk factors as main pathogenic factors were identified in this study.