Analysis Of Curative Effect Of ERCP For Patients With Choledocholithiasis And Diabetes Mellitus

Objective: Clinical treatment of patients with common bile duct stones with type II diabetes mellitus was guided by comparing clinical data of CBDS patients with or without type II diabetes mellitus to identify complications and risk factors for recurrence of stones after ERCP lithotripsy.Method: 260 patients with primary common bile duct stones had ERCP lithotripsy after admission to Qinghai university hospitals between September 30,2016 and March 30,2021.According to whether it is accompanied by type II diabetes mellitus,it is divided into the group with diabetes mellitus(CDG group)and the group without diabetes mellitus(NDG group).Analyzed the general condition,laboratory,clinical indicators,hospital stay length,and medical costs of both groups.An analysis of stone recurrence and early postoperative complications in the CDG group was conducted using a binary logistic regression model,the influencing factors of hospitalization expenses in this group were screened with a multiple regression linear model.Result: The serum albumin index in the CDG group was lower than that in the NDG group(P<0.05),and the preoperative fasting blood glucose in the CDG group was higher(P<0.05);the CBD diameter> was 1.49 cm,the stone diameter > 1.0 cm,in addition,the guide wire entering the pancreatic duct was statistically significant(P<0.05),there was no statistical significance between the two groups(P>0.05)for cholangitis and pancreatitis indicators in postoperative complications,however,medical expenses were higher for the CDG group(P<0.05).Age,multiple stones,guide wire into the pancreatic duct,and nipple dilation are independent risk factors for the development of hyperamylaseemia after CDG group,nipple diverticulum and nipple dilation are independent risk factors for postoperative PEP in CDG group,WBC and EST are independent risk factors for postoperative cholangitis in CDG group,postoperative cholecystectomy,ERCP history,abnormal total bilirubin index after surgery,and papillotomy are independent risk factors for postoperative stone recurrence.Multiple linear regression model showed that there was a positive linear relationship between hospitalization days,WBC,intraoperative basket lithotomy,men and medical expenses.Conclusion: The influencing factors of postoperative complications in patients with common bile duct stones with type II diabetes mellitus are the result of the inter action of various factors,such as nipple dilation is a common independent risk factor for hyperamylaseemia and pancreatitis;EST is a common independent risk factor fo r cholangitis and stone recurrence,and an individualized treatment plan should be gi ven before surgery in combination with the patient’s condition and whether there are high risk factors associated with related complications to reduce the risk of complica tions in the postoperative period,and the treatment plan should be adjusted in a timel y manner by strengthening patient follow-up outside the hospital.