Analysis of Risk Factors for Postoperative Complications of Laparoscopic Retrograde Cholecystectomy for Complex Gallbladder Stones
ZHAN Xian-feng,QIU Jun,XIANG Ben-hong
Abstract:
Objective To explore the risk factors of complications after laparoscopic retrograde cholecystectomy (LRC) for the treatment of complex gallbladder stones (CGS) and provide reference value for the identi.cation of clinical risk factors. Methods The 237 CGS patients treated with LRC who were admitted to our hospital from March 2019 to March 2021 were selected as the research objects. According to the occurrence of postoperative complications, the patients were divided into uncomplicated group (220 cases) and complication group (17 cases). The general data of the two groups of patients were compared. The single-factor and multi-factor Logisitic regression analyzed the factors affecting the occurrence of postoperative complications in patients. A risk scoring model was constructed and its predictive value was evaluated. Results Postoperative complications included 3 cases of bile duct injury, 3 cases of cystic duct excessive length, 4 cases of calculus and 7 cases of bile leakage. The complication rate was 7.17% (17/237). The diabetes, gallbladder wall thickness >5 mm, gallbladder neck stones, adhesions of surrounding organs, Calot triangle adhesions and emergency surgery are all risk factors that affect the occurrence of complications after LRC in CGS patients (P<0.05). The above risk factors were included in the risk score. The model assigns weights of 19, 35, 42, 31, 38 and 27 points respectively. The total scores ≤ 69 points are de.ned as the intermediate risk group, >69 points and ≤ 152 points are de.ned as the high-risk group, and >152 points are de.ned as the extremely high-risk group. The model predicts better discrimination and calibration. Conclusion Analyzing the risk factors of complications after LRC in CGS patients and constructing a risk scoring model are conducive to early clinical identification of high-risk groups, which is of great significance for reducing the incidence of postoperative complications and improving the prognosis of patients.
