Analysis Of Risk Factors Of Perioperative Cholestasis And Cholecystitis In Patients With Gastrointestinal Tumor

Objective:To investigate the risk factors of postoperative cholestasis or acute acalculous cholecystitis in patients with gastrointestinal tumors.Method:To collect the inpatient data of patients undergoing gastrointestinal tumor surgery in our hospital from January 2017 to December 2019 and retrieve the information of the patients with cholestasis or AAC.Through comparing and analyzing the basic information,operation information and parenteral nutrient solution,the risk factors are obtained,then Logistic multivariate analysis was performed for the screened risk factors to evaluate the correlation of risk factors.Result:1583 cases were searched,among which 1060 cases met the inclusion criteria,including 3 patients with AAC(incidence: 0.28%),26 patients with cholestasis(incidence: 2.45%),and 171 patients with mild abnormalities of either ?-GT or ALP(incidence: 16.13%).The application time,fasting time,operation time and anesthesia time of TPN in patients with cholestasis or acute acalculous cholecystitis were longer than those in the normal group,and the blood pressure fluctuation range was higher(P<0.05).Different kinds of fat emulsions and amino acid solutions,hypertension and diabetes,the thermo-nitrogen ratio and the glycoliptolipid ratio of TPN had no statistical significant effect(P > 0.05).The surgical method and intraoperative application of vasoactive drugs were statistically significant(P < 0.05),surgical administration of vasoactive agents(OR=2.857,OR95%C.I=1.066-6.652,P=0.037)was a risk factor.Conclusion:Vasoactive agents was a risk factor.Perioperative period should ensure the stability of blood perfusion and hemodynamics,reduce the ischemia-reperfusion injury of the gallbladder,actively control the infection,stabilize the intestinal microenvironment,and start the intestinal tract through oral feeding as soon as possible.