Analysis Of The Risk Factors For Recurrence Of Hepatolithiasis After Operation And The Preventive Effect Of Lidan Traditional Chinese Medicine

Objectives : Hepatolithiasis is a common clinical disease and surgery is the main treatment,but have a higher recurrence rate of hepatolithiasis after operation.Through retrospective clinical case studies,objective to explore the risk factors of postoperative recurrence of hepatolithiasis and the preventive effect of Lidan traditional Chinese medicine,so as to provide reference for preventing postoperative recurrence of hepatolithiasis.Methods:Data of 107 patients with hepatolithiasis admitted from January 2010 to January 2017 in the First Affiliated Hospital of Da Lian Medical University were collected.Before operation,all patients underwent abdominal color ultrasound,CT,MRCP and other imaging assistant examinations to determine intrahepatic cholelithiasis,and all patients had corresponding surgical indications,and were treated by operation during hospital.The operation included hepatectomy +choledocholithotomy + T tube drainage(Including only hepatectomy)and choledocholithotomy + T tube drainage.A total of 100 successful cases were followed up by telephone and out-patient follow-up.According to criteria of recurrence of hepatolithiasis,they were divided into two groups: Recurrence group and non-recurrence group.The differences between the following indicators in the two groups were analyzed statistically and inserted into logistic regression analysis:Sex,age,history of smoking,history of alcohol consumption,history of hypertension,history of diabetes mellitus,diameter of common bile duct,operative method,distribution of intrahepatic bile duct stones,maximum diameter of stones,and complicated with extrahepatic bile duct stones.stricture of hepatobiliary duct and residual stone after operation.The patients were treated with Lidan traditional Chinese medicine(Qing Re Li Dan granule or Lidan decoction)after operation,and according to the situation that continued regular use Qing Re Li Dan granule or Lidan decoction for half a year,the patients were divided into Chinese medicine group and non Chinese medicine group.Through ?2,test whether there is a statistical difference between the two groups of data.Results:Of 107 cases,100 patients were followed up effectively,and complete cases were obtained.The effective follow-up rate was 93.5%.There were 19 cases of recurrent patients and 81 cases without recurrence,and recurrence rate was 19%.The shortest time of postoperative recurrence for 7 months,the longest time of recurrence was 64 months,the first year the cumulative recurrence rate was 6%,second years the cumulative recurrence rate was 11%,third years the cumulative recurrence rate was15%,fourth years the cumulative recurrence rate was 17%,fifth years the cumulative recurrence rate was 18%,and sixth years cumulative recurrence the rate is 19%.There was no statistical difference in age using t test single factor analysis.Univariate Chi-square test was used to analyze sex,hypertension,diabetes,smoking,alcohol consumption,operation,common bile duct diameter,distribution of intrahepatic bile duct stones,maximum diameter of stones,stricture of intrahepatic bile duct,residual stones;There were significant differences in sex,distribution of intrahepatic bile duct stones,stricture of intrahepatic bile duct stones and residual stones in the above factors.(P<0.05).The single factor with statistical difference was introduced into the multivariate logistic regression analysis.The results showed that there were stones distributed bilaterally(P=0.030,OR=3.688),intrahepatic bile duct stenosis(P=0.024,OR=3.964),residual stones(P=0.010,OR=4.626)as independent risk factors for recurrence of intrahepatic cholelithiasis.And sex(P=0.116)is not an independent factor for the recurrence of intrahepatic cholelithiasis.Compared with the control group,the prevention of postoperative calculi recurrence in Lidan Chinese traditional medicine group was significantly different from that in the control group.(P<0.05)It is suggested that Lidan Chinese traditional medicine can prevent the recurrence of intrahepatic cholelithiasis after operation.Conclusion : The risk factors for recurrence of hepatolithiasis in patients with intrahepatic bile duct stones are bilateral,stenosis of intrahepatic bile ducts and residual stones after operation.Regular use the Lidan Chinese traditional medicine have a certain effect on preventing the recurrence of hepatolithiasis after operation.