Exploring the risk factors of biliary leakage after laparoscopic cholecystectomy:based on propensity score matching method
Objective:To explore the risk factors of biliary leakage after laparoscopic cholecystectomy based on propensity score matching method.Methods:The clinical data of 1 031 patients who underwent laparoscopic chole-cystectomy in our hospital from February 2017 to June 2023 were retrospectively analyzed,and they were divided into concurrent group(n=56)and non-concurrent group(n=975)based on whether postoperative biliary leak-age.The data of age,gender,body mass index(BMI),smoking history,drinking history,hypertension history,diabetes history,Child-Pugh classification and American Society of Anesthesiology(ASA)classification of the con-current group and the non-concurrent group were matched according to the 1:1 ratio using propensity score matc-hing method.After matching,the risk factors of biliary leakage after laparoscopic cholecystectomy were analyzed using Logistic regression analysis method.Results:After matching,51 pairs of patients were successfully matched between the concurrent group and non-concurrent group through the ratio of 1∶1,and the age,gender,BMI,smoking history,drinking history,hypertension history,diabetes history,Child-Pugh classification and ASA classi-fication of the two groups were balanced(P＞0.05).After matching,there was no statistically significant differ-ence between the two groups in terms of surgical time,gallbladder atrophy,gallbladder inflammation,gallbladder neck stones and the number of gallbladder stones(P＞0.05),and the proportion of the chief surgeon's clinical ex-perience＜5 years,local anatomical variation,Calot triangle adhesion,adhesion between gallbladder and surround-ing organs and gallbladder wall thickness ≥ 5 mm in the concurrent group were higher than those in the non-concur-rent group(P＜0.05).Logistic regression analysis showed that chief surgeon's clinical experience＜5 years,local anatomical variation,Calot triangle adhesion,adhesion between gallbladder and surrounding organs and gallbladder wall thickness ≥5 mm were independent risk factors for biliary leakage after laparoscopic cholecystectomy(P＜0.05).Conclusion:After propensity matching the data of age,gender,BMI,smoking history,drinking history,hypertension history,diabetes history,Child-Pugh classification and ASA classification,chief surgeon's clinical ex-perience＜5 years,local anatomical variation,Calot triangle adhesion,adhesion between gallbladder and sur-rounding organs and gallbladder wall thickness ≥5 mm are risk factors for biliary leakage after laparoscopic chole-cystectomy.
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