肝门部胆管癌术后严重并发症的回顾性分析

摘要

Objective To investigate the risk factors which work on the serious postoperative complication in patients with hilar cholangiocarcinoma. Methods Seventy-four cases of hilar cholangiocarcinoma treated by surgery were reviewed retrospectively. The logistic regression analysis was used to evaluate the risk factors of serious postoperative complications. Eight factors including gender, age, accompanied diseases, tumor type, pre⁃operative jaundice, preoperative albumin, preoperative liver function and operative manners were chosen as risk factors for simple and multiple logistic regression analysis. Defining P<0.05 for statistical significance. Results In this research, postoperative complications occurred in 23 of 74(31.1%). The univariate analysis showed four factors might work on the occurrence of the serious postoperative complications, including age(P=0.036), tumor type(0.045), preoperative liver function(P=0.001), and operative manner(P=0.012). The further mul⁃tivariate analysis showed that three of them played a role in the occurrence of the serious postoperative complica⁃tions. They were age(P=0.035), preoperative liver function(P=0.000) and operative manner(P=0.001). All of them related positively to the serious postoperative complications. Conclusion Age, preoperative liver function and operative manner were risk factors of serious postoperative complications in hilar cholangiocarcinoma.%目的：探讨影响肝门部胆管癌术后严重并发症发生的危险因素。方法：对经外科手术切除治疗的74例肝门部胆管癌病例资料进行回顾性分析，采用Logistic回归分析法分析可能影响肝门部胆管癌术后严重并发症发生的危险因素，选择性别、年龄、术前合并症、肿瘤分型、术前黄疸程度、术前白蛋白水平、术前肝功能分级、手术方式等8个指标作为危险因素分别进行单因素和多因素Logistic回归分析。结果：术后出现严重并发症23例（31.1%）；单因素分析显示，年龄、肿瘤分型、术前肝功能分级和手术方式与术后出现严重并发症相关联；多因素分析显示，年龄、术前肝功能分级和手术方式对术后出现严重并发症有影响，且均为正相关。结论：年龄、术前肝功能和手术方式是肝门部胆管癌术后严重并发症发生的危险因素。