Analysis Of Risk Factors For Laparoscopic Common Bile Duct Exploration In The Treatment Of Common Bile Duct Stones

Objective: To identify the risk factors for laparoscopic common bile duct exploration(LCBDE)in the treatment of common bile duct stones.Methods: A retrospective study was performed on the clinical data of 206 patients who underwent LCBDE due to common bile duct stones in the second department of general surgery of Shengjing Hospital of China Medical University from June2018 to September 2020.The patients whose operative time was longer than the average operative time of the surgeons,or converted,or residual common bile duct stones were included in the difficult group(96 cases,46.61%),while the others were included in the easy group(110 cases,53.39%).Risk factors associated with difficulty in LCBDE were determined by univariate and multivariate analys is.Results: Among 206 patients with LCBDE,96 were in the difficult group and 110 were in the easy group.Single-factor analysis determined that the risk factor associated with surgical difficulties was whether the diameter of common bile duct greater than 1cm and incarceration of common bile duct stones.Then,it was conducted logistic regression analysis,and the independent risk factors were the common bile duct diameter greater than 1cm [regression coefficient was 0.658,OR=1.931,95%CI:1.078～3.459,P=0.027] and incarceration of common bile duct stones [regression coefficient was 1.430,OR=4.181,95%CI:1.682～10.390,P=0.002].Conclusion: For patients with common bile duct stones,preoperative examination indicated that the difficulty of operation was increased when the diameter of the common bile duct was greater than 1cm and incarceration of common bile duct stones.