Analysis The Difference Of Secondary Hepatolithiasis After Different Lithotomy For Extrahepatic Bile Duct Stone And Analysis Of It's Clinical

Objective: To study the difference of intrahepatic choledocholithiasis secondary to different extrachepatic choledocholithiasis after lithotomy and analyze the reason that may lead to the difference.Methods: The patients with extrahepatic bile duct stones admitted to our hospital from January 2012 to December 2016 were selected as the research objects.The case data of postoperative intrahepatic bile duct stones in the study subjects were collected for retrospective analysis.1.The incidence of intrahepatic bile duct stones in different extrahepatic bile duct calculi surgery way: the differences between the study will be incorporated into the object of study of patients with extrahepatic bile duct stones according to the operation method,divided into ERCP and cut take bravery manager stone group,the comparison between the two groups the incidence of postoperative intrahepatic biliary calculi,and through the statistical analysis software to determine whether a difference was statistically significant;2.Study on risk factors of intrahepatic cholelithiasis in patients with extrahepatic cholelithiasis after surgery:the experimental group was patients with intrahepatic cholelithiasis after surgery,and the control group was patients without intrahepatic cholelithiasis randomly selected.Univariate analysis was performed on the clinical data of the two groups of patients,and multivariate Logistic regression analysis was performed on the selected risk factors,finally independent risk factors were obtained.3.Derivation of the possible mechanism of intrahepatic cholelithiasis secondary to surgery in patients with extrahepatic cholelithiasis: by comparing the above risk factors among patients with extrahepatic cholelithiasis with different surgical methods,derivation of the possible mechanism of intrahepatic cholelithiasis secondary to different surgical methods was made.Results: 1.The choledocholithotomy group was more prone to secondary intrahepatic bile duct stones than the ERCP group in the case of recurrent stones;2.The single factor analysis found that the experimental group on the following clinicaldata exist significant difference with control group with statistical significance(P <0.05),including: history of gallbladder surgery,biliary stricture,common bile duct expansion(diameter 15 mm or higher),stone size(10 mm or higher),high-density lipoprotein cholesterol(1.29 or higher tendency/L),direct bilirubin after rise(acuity13.68 umol/L).Multivariate analysis showed that: history of gallbladder surgery,biliary stricture,common bile duct dilatation,high density lipoprotein cholesterol and postoperative direct bilirubin were independent risk factors.3.Whether the cholecystectomy was performed in the extrahepatic bile duct stones was different between the groups of different lithotomy.Conclusion: Choledocholithotomy after extrahepatic choledocholithotomy is more likely to cause intrahepatic choledocholithotomy than ERCP choledocholithotomy in the case of recurrent stones,and cholecystectomy may be the mechanism leading to this difference.