微创保胆取石术治疗胆囊结石患者结石复发风险因素分析研究*

doi:10.3969/j.issn.1672-5069.2026.04.034

摘要/Abstract

摘要： 目的探讨微创保胆取石术治疗的胆囊结石患者术后结石复发的影响因素。方法 2022年1月～2024年12月我院收治的244例胆囊结石患者,术前均接受彩色多普勒超声检查,测量并记录收缩期峰值流速(PSV)、舒张末期流速(EDV)和平均流速(Vm)。所有患者均接受腹腔镜下保胆取石术治疗,随访1年,使用彩色多普勒超声检查诊断结石复发。采用多因素Logistic回归分析影响术后结石复发的独立危险因素。结果本组患者术后随访1年,发现胆囊结石复发29例(11.9%);复发组胆囊壁厚度、合并结石嵌顿占比和超声检测的EDV水平分别为(2.8±0.4)mm、13.8%和(10.9±2.2)cm/s,均显著大于未复发组【分别为(2.4±0.2)mm、3.7%和(9.2±1.4)cm/s,P＜0.05】;多因素Logistic回归分析显示,胆囊壁厚、合并结石嵌顿和EDV高水平是保胆取石术后胆囊结石复发的独立危险因素(OR=14.534,OR=4.656,OR=1.329,P<0.05)。结论采用腹腔镜下保胆取石术治疗胆囊结石患者可能存在结石复发的风险,了解这些影响因素并给予针对性的防治措施,或许能提高治疗效果。

关键词: 胆囊结石, 腹腔镜下保胆取石术, 多普勒超声, 结石复发, 危险因素

Abstract: Objective This study aimed to investigate risk factors for postoperative stone recurrence after laparoscopic gallbladder-preserving cholecystolithotomy in patients with gallstones. Methods A total of 244 consecutive patients with gallstones were encountered in our hospital between January 2022 and December 2024, and all patients underwent before operation color Doppler ultrasonography to record peak systolic veIocity (PSV), end diastolic velocity (EDV) and mean flow velocity (Vm) of gallbladder artery. All patients underwent laparoscopic cholecystolithotomy, and were followed-up for one year. Multivariate Logistic regression analysis was applied to identify independent risk factors for postoperative stone recurrence. Results The stone recurrence rate was 11.9% (29/244) in our series by end of one-year follow-up after surgery; the gallbladder wall thickness, proportion of stone impaction and EDV level in the stone recurrence group were(2.8±0.4)mm, 13.8% and (10.9±2.2)cm/s, all significantly greater than [(2.4±0.2)mm, 3.7% and (9.2±1.4)cm/s, respectively, P＜0.05] in non-recurrence group; multivariate Logistic regression analysis showed that thicken gallbladder wall (OR=14.534,P<0.05), impacted stone (OR=4.656,P<0.05) and increased EDV level(OR=1.329,P<0.05) were all the independent risk factors for stone recurrence. Conclusion Gallstone might recur after laparoscopic cholecystolithotomy in patients with gallbladder stones, and color Doppler ultrasound could be the best postoperative follow-up strategies to find it early.

Key words: Gallstones, Laparoscopic cholecystolithotomy, Color doppler ultrasound, Postoperative stone recurrence, Risk factors

夏炜, 丛苗苗. 微创保胆取石术治疗胆囊结石患者结石复发风险因素分析研究^*[J]. 实用肝脏病杂志, 2026, 29(4): 613-616.

Xia Wei, Cong Miaomiao. Risk factors for postoperative stone recurrence after laparoscopic cholecystolithotomy in patients with gallstones[J]. Journal of Practical Hepatology, 2026, 29(4): 613-616.

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微创保胆取石术治疗胆囊结石患者结石复发风险因素分析研究^*

Risk factors for postoperative stone recurrence after laparoscopic cholecystolithotomy in patients with gallstones

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