Risk Factors and Predictive Efficacy of Pancreatitis After Laparoscopic Minimally Invasive Lithotomy in Elderly Patients with Gallbladder Stones and Common Bile Duct Stones
Objective To investigate the risk factors and predictive efficacy of pancreatitis after laparoscopic minimally invasive lithotomy in elderly patients with gallbladder stones(GS)and common bile duct stones(CBDS).Methods A total of 372 elderly patients with GS complicated with CBDS who underwent laparoscopic minimally invasive lithotomy in Nanyang Central Hospital from January 2020 to January 2023 were selected.They were divided into pancreatitis group and non pancreatitis group based on whether they developed pancreatitis after surgery.Univariate and binary logistic regression analysis were used to analyze the risk factors of pancreatitis after laparoscopic minimally invasive lithotomy in elderly patients with GS and CBDS.Results The incidence of pancreatitis after laparoscopic minimally invasive lithotomy in 372 elderly patients with GS and CBDS was 13.71％.The proportion of patients with peripapillary diverticulum,pancreatic duct visualization,pancreatic sphincterotomy,pancreatic stent and nasobiliary drainage in the pancreatitis group were 68.63％,76.47％,58.82％,and 45.10％,respectively,which were higher than those in the non pancreatitis group 33.33％,34.89％,19.31％,and 21.50％(P＜0.05).Peripapillary diverticulum,pancreatic duct imaging,pancreatic stent and nasobiliary drainage and pancreatic sphincterotomy were independent risk factors for pancreatitis after laparoscopic minimally invasive lithotomy in elderly patients with GS and CBDS(P＜0.05).The logistic regression model showed an area under the curve of 0.860(95％CI:0.792-0.933)for pancreatitis after laparoscopic minimally invasive lithotomy in elderly patients with GS and CBDS,the sensitivity was 90.20％,and the specificity was 67.29％.Conclusion There is a higher risk of pancreatitis after laparoscopic minimally invasive lithotomyin elderly patientselderly patients with GS and CBDS,which is mainly related to parapillary diverticulum,pancreatic duct imaging,pancreatic stent and nasobiliary drainage and pancreatic duct sphincterotomy,etc.The prediction model built based on the above factors has good prediction efficacy.Targeted preventive interventions against the aforementioned risk factors can reduce the occurrence of postoperative pancreatitis and improve the prognosis of patients.
gallbladder stonecommon bile duct stonelaparoscopic minimally invasive lithotomypancreatitis
万方数据
维普
