Analysis Of Influencing Factors And Prevention Strategies Of Complications After Radical Operation Of Congenital Choledochal Cyst In Children

Objective: To explore the influencing factors of postoperative complications of congenital choledochal cyst in children,and to provide some clinical basis and guidance for reducing postoperative complications.Methods: Retrospective analysis of clinical data of 124 children with congenital choledochal cysts diagnosed and radically treated in our hospital from September 2010 to October 2019,29 males and 95 females,depending on whether they occurred after surgery Complications(biliary leakage,gastrointestinal anastomotic fistula,bleeding,incision dehiscence,cholangitis,abdominal infection,pancreatitis,and lymphatic fistula)were divided into complications group(A)and non-complication group(B).Statistics of two groups of children age,laboratory indicators(preoperative white blood cell count,hemoglobin,glutamic pyruvic transaminase,prealbumin and postoperative albumin),and two groups of children with operation method,operation time,intraoperative blood loss,cyst type,cyst diameter,hepatic duct diameter diameter,whether abdominal operation history,biliary mud calculus,hepatic duct anatomic variation,aomalous pncreatico biliary dctal uion of clinical indicators.The measurement data(age,preoperative leukocyte count,postoperative albumin,intraoperative blood loss,and cyst diameter)in the two groups.By comparison,the T test was used for the normal distribution,and the non-parametric rank sum test was used for the non-normal distribution.Multivariate analysis was performed using Logistic regression analysis.Results: Twenty-five cases(20.16%)of complications occurred in 124 surgical children,99 cases(79.84%)had no complications,of which 14 cases were bile leaks(11.29%),7cases were operated again,and 7 cases were cured conservatively;2 cases of intestinal anastomotic fistula(1.61%),1 case was re-operated,and 1 case was cured conservatively;1 case(0.81%)of postoperative blood loss was cured by re-operation;2 cases(1.61%)of incision dehiscence,1 case was re-operation,and 1 case was conservatively cured;Two cases(1.61%)of cholangitis,2 cases of abdominal infection(1.61%),1 case of pancreatitis(0.81%),and 1 case of lymphatic fistula(0.81%)were all conservatively cured.Among them,non-normal distribution indicators: the age and white blood cell count,there was no significant difference between the two groups(P>0.05);blood loss Volume,cyst diameter,the difference between the two groups was statistically significant(P<0.05);Met the normal distribution indicators: postoperative albumin(27.84±4.62)&(32.45±3.72)g/L,the difference between the two groups was statistically significant(P<0.05).Logistic multivariate regression analysis: preoperative anemia(OR=7.922,95%CI:1.468~42.757),combined with biliary mud calculus(OR=1.295,95%CI:1.075~4.359)were independent risk factors for postoperative complications;But,postoperative albumin(OR=0.055,95%CI:0.012~0.244)is a protective factor for postoperative complications,and the difference is statistically significant(P<0.05).Conclusion:(1)The occurrence of complications after radical operation of congenital choledochal cyst was not related to the age of the child and the preoperative white blood cell count,but related to the diameter of the cyst and the amount of intraoperative hemorrhage.The larger the diameter of the cyst,the more intraoperative hemorrhage and the higher the risk of operation.(2)Preoperative anemia and combined with biliary mud calculus were independent risk factors for postoperative complications of congenital choledochal cyst.Postoperative albumin was a protective factor for postoperative complications.(3)Correcting anemia before surgery,clearing liver and bile duct silt during operation,reducing bleeding,and strengthening the monitoring of albumin and hemoglobin during perioperative period can prevent and reduce complications after radical operation of congenital choledochal cyst in children.