Analysis Of Related Factors Of Postoperative Complication For Patients With Obstructive Jaundice

Objective: To explore the related factors of obstructive jaundice patients postoperative complications occurredMethods: Collecting 152 cases patients with OJ disease coming from general surgery of the first clinical hospital of Shanxi medical university form2015.4.1to2016.1.30.And Recording various factors which may be associated with postoperative complications. Inclusion criteria: 1 make a definite diagnosis of OJ on the basis of signs, laboratory and imaging; 2, the first treatment of this disease; 3, clear consciousness and the language communication skills; 4, no congenital diseases, physical deformities, deformity and major organs serious obstacle, etc; 5 voluntary, cooperate with this research and informed. Exclusion criteria: 1, eliminating cases mergering cachexia, tuberculosis, kidney disease, thyroid dysfunction and other diseases such as high consumption of rare disease; 2 eliminating cases of Data shortageor loss.Results: Patients conforming to criteria and eligible for NRS2002 standard of nutritional risk screening are152,Patients with nutritional risk for 116(76.3%); Male, 66(43.4%),Lost opportunities or transfer operation for 13 patients. 139 cases of patients, for 33(23.7%) cases of complications. For 109(78.4%) cases with nutritional risk, the difference was statistically significant(chi-square = 0.014, P < 0.05). Men of 59(43%), postoperative complications in patients with men for 19(58%) cases, difference was statistically significant(chi-square = 4.055, P < 0.05). Age > 65 58cases(42%), which the postoperative complications in patients with age > 65 years of 21(63.6%) cases, the difference was statistically significant(chi-square = 8.543, P < 0.05). BMI < 25 to 98(70%) cases, including postoperative complications in patients with BMI < 25 26(79%) cases, there was no statistically significant difference(chi-square = 1.428, P > 0.05); But BMI < 20 for 46 cases(33%), the postoperative complications in patients with BMI < 20 of 26(79%) cases, the difference was statistically significant(chi-square = 40.807, P < 0.05). for106(76%) patients with benign lesions, the postoperative complications in patients with 13(45%) patients with benign lesions. The difference was statistically significant(chi-square = 19.997, P < 0.05). Various studies for operation method, difference was statistically significant(chi-square = 24.331, P <0.05), But for the research for operation method of benign disease, malignant disease cases respectively, Laparoscopic cholecystectomy + take bravery manager stone + T tube drainage, ENBD + EST compare to the traditional open cholecystectomy + bravery manager stone + T tube drainage for benign disease, there was no statistically significant difference(chi-square = 0.548, P > 0.05),(chi-square = 3.270, P > 0.05); Joint resection of gallbladder and bile duct, pancreatic duodenal carcinoma radical or neoplasm resection of head of pancreas for Malignant disease, there was no statistically significant difference(chi-square = 0.293, P > 0.05). The difference of PA and transferrin was statistically significant(P < 0.05) on admission. These index data of ALT、AST、total protein、albumin and TB changes over time were statistically significant(P < 0.05), and the datum of ALT, AST in complications obviously increased on the seventh day. Decreasing total protein and albumin after admission, at minimum 3 days postoperatively, and slowly rise, and groups of patients with complications total protein and albumin average than the same period patients’ without complications set of albumin in patients with lower average. The datum of patients complications’ TB group are obviously higher than that of group did not occur.Conclusion: 1.when having the following characteristics the OJ patients are at greater risk ofcomplications: NRS2002 grade 3 or male, Age > 65 years old, BMI<20, Patients with malignant disease. 2. The following laboratory tests index warn higher probability of complications for OJ patients: Lower albumin before admission, Lower transferrin before admission, Postoperative day 3 lower albumin, Postoperative day 7 ALT elevations, AST rise 7 days postoperatively. 3. Decreasing total protein and albumin after admission, at minimum 3 days postoperatively, and slowly rise, and groups of patients with complications total protein and albumin average than the same period patients without complications set of albumin in patients with lower average. The datum of TB continued at a higher level.