Analysis Of Risk Factors For Recurrence Of Hepatolithiasis After Operation

Objective:Hepatolithiasis is a common and frequently-occurring disease in biliary surgery with complex pathogenesis and high postoperative residual stone rate and recurrence rate.Through the retrospective analysis of clinical related cases,this paper studies the influence of related factors on postoperative stone recurrence,and discusses the risk factors of recurrence after operation,in order to provide new ideas for the prevention and treatment of hepatolithiasis.Methods:The clinical data of 115 patients with hepatolithiasis treated in the second Hospital of Jilin University from January 2014 to January 2019 were collected and followed up.According to the inclusion and exclusion criteria,106 cases were included.The patients were divided into recurrent group and non-recurrent group according to whether they relapsed after operation.SPSS25.0 software was used to analyze the differences of related factors such as sex,age,smoking history,drinking history,hyperlipidemia,first operation,stone distribution,bile duct stricture and cholangiocarcinoma between the two groups.P<0.05 indicates that it is statistically significant.The related factors with statistical significance were brought into Logistic regression model for analysis.Results:Among the 106 cases with follow-up and complete clinical data,there were 29 patients in the recurrence group and 77 patients in the non-recurrence group,with a recurrence rate of 27.4%.In the univariate analysis of age,there was no significant difference in t-test,and chi-square test was used in the analysis of other factors,including gender,smoking history,drinking history,hyperlipidemia and cholangiocarcinoma,but there were significant differences in the first operation(P=0.001),stone distribution(P=0.013)and bile duct stricture(P=0.005).The above statistically significant recurrence factors were analyzed in Logistic regression model.The results showed that the first surgical procedure(P=0.335)was not a factor affecting recurrence,while bilateral stone distribution(P=0.041,OR=1.979)and intrahepatic bile duct stricture(P=0.021,OR=3.166)were the independent risk factors for stone recurrence after operation.Conclusions:1.Bilateral distribution of stones and bile duct stricture are independent risk factors for postoperative recurrence of hepatolithiasis.2.Partial hepatectomy can remove the diseased narrow bile duct,thereby completely solving the problem of bile duct stenosis.Therefore,it has certain advantages in reducing the recurrence rate of stones.