单孔腹腔镜胆囊切除术的并发症及影响因素分析

目的:探讨单孔腹腔镜胆囊切除术(SILC)并发症及其影响因素。方法:收集2011年1月至2019年6月收治的977例行SILC患者的临床资料,分析并发症发生情况及相关影响因素。先后采用χ~2检验与多因素logistic回归分析SILC并发症的19个相关因素。结果:本组共21例患者出现并发症,发生率为2.15%。χ~2检验结果显示,并发症与Calot三角粘连、胆囊区解剖变异、急性期、腹部手术史及胆囊壁厚度超过5 mm有关(P<0.05)。多因素Logistic回归分析结果显示,Calot三角粘连(P<0.05,OR=6.537)、胆囊区解剖变异(P<0.05,OR=5.253)、腹部手术史(P<0.05,OR=4.762)、胆囊壁厚度(P<0.05,OR=4.318)是SILC并发症发生的危险因素。结论:术前充分评估围术期可能存在的危险因素,以降低并发症发生率,提高SILC的安全性。

Complications and influencing factors of single-incision laparoscopic cholecystectomy

Objective:To investigate the complication of single incision laparoscopic cholecystectomy and its influencing factors.Methods:The clinical data of 977 patients who underwent single incision laparoscopic cholecystectomy from Jan.2011 to Jun.2019 were collected to analyze the complications and related influencing factors.Statistical analysis was performed on 19 factors related to complications of single incision laparoscopic cholecystectomy using χ~2 test and multivariate logistic analysis.Results:Complications occurred in 21 patients and the incidence of single incision laparoscopic cholecystectomy complications was 2.15%. χ~2 test results showed that single incision laparoscopic cholecystectomy complications were associated with Calot triangle adhesion,anatomical variation of the gallbladder area,acute phase,abdominal surgery history and gallbladder wall thickness more than 5 mm(P<0.05).Multivariate logistic regression analysis showed that Calot triangular adhesion(P<0.05,OR=6.537),anatomical variation of gallbladder area(P<0.05,OR=5.253),history of abdominal surgery(P<0.05,OR=4.762),thickness of gallbladder wall(P<0.05,OR=4.318) were risk factors for single incision laparoscopic cholecystectomy complications.Conclusions:Surgeons should fully evaluate the possible risk factors during the perioperative period,reduce the incidence of complications,and improve the safety of single incision laparoscopic cholecystectomy.