PDF(Pubmed)
Abstract：
BACKGROUND: A comprehensive understanding of the extrahepatic bile duct anatomy is vital to guide surgical procedures and perform endoscopic retrograde cholangiography. Anatomical irregularities within the extrahepatic bile duct may increase susceptibility to bile duct stones.
OBJECTIVE: To investigate the anatomical risk factors associated with extrahepatic bile ducts in patients diagnosed with choledocholithiasis, with a specific focus on preventing stone recurrence after surgical intervention and endoscopic lithotomy.
METHODS: We retrospectively analyzed the medical records of 124 patients without choledocholithiasis and 108 with confirmed choledocholithiasis who underwent magnetic resonance cholangiopancreatography examinations at our center between January 2022 and October 2022. Logistic regression analyses were conducted to identify the anatomical risk factors influencing the incidence of common bile duct stones.
RESULTS: Multivariate logistic regression analysis revealed that several factors independently contributed to choledocholithiasis risk. Significant independent risk factors for choledocholithiasis were diameter of the common hepatic [adjusted odds ratio (aOR) = 1.43, 95% confidence interval (CI): 1.07-1.92, adjusted P value = 0.016] and common bile (aOR = 1.68, 95%CI: 1.27-2.23, adjusted P value < 0.001) ducts, length of the common hepatic duct (aOR = 0.92, 95%CI: 0.84-0.99, adjusted P value = 0.034), and angle of the common bile duct (aOR = 0.92, 95%CI: 0.89-0.95, adjusted P value < 0.001).
CONCLUSIONS: The anatomical features of the extrahepatic bile duct were directly associated with choledocholithiasis risk. Key risk factors include an enlarged diameter of the common hepatic and bile ducts, a shorter length of the common hepatic duct, and a reduced angle of the common bile duct.
OBJECTIVE: To investigate the anatomical risk factors associated with extrahepatic bile ducts in patients diagnosed with choledocholithiasis, with a specific focus on preventing stone recurrence after surgical intervention and endoscopic lithotomy.
METHODS: We retrospectively analyzed the medical records of 124 patients without choledocholithiasis and 108 with confirmed choledocholithiasis who underwent magnetic resonance cholangiopancreatography examinations at our center between January 2022 and October 2022. Logistic regression analyses were conducted to identify the anatomical risk factors influencing the incidence of common bile duct stones.
RESULTS: Multivariate logistic regression analysis revealed that several factors independently contributed to choledocholithiasis risk. Significant independent risk factors for choledocholithiasis were diameter of the common hepatic [adjusted odds ratio (aOR) = 1.43, 95% confidence interval (CI): 1.07-1.92, adjusted P value = 0.016] and common bile (aOR = 1.68, 95%CI: 1.27-2.23, adjusted P value < 0.001) ducts, length of the common hepatic duct (aOR = 0.92, 95%CI: 0.84-0.99, adjusted P value = 0.034), and angle of the common bile duct (aOR = 0.92, 95%CI: 0.89-0.95, adjusted P value < 0.001).
CONCLUSIONS: The anatomical features of the extrahepatic bile duct were directly associated with choledocholithiasis risk. Key risk factors include an enlarged diameter of the common hepatic and bile ducts, a shorter length of the common hepatic duct, and a reduced angle of the common bile duct.
摘要：
背景：全面了解肝外胆管解剖结构对于指导外科手术和进行内窥镜逆行胆管造影至关重要。肝外胆管解剖不规则可能增加胆管结石的易感性。
目的：探讨胆总管结石患者肝外胆管解剖危险因素。特别关注预防手术干预和内镜碎石术后结石复发。
方法：我们回顾性分析了2022年1月至2022年10月在我们中心接受磁共振胰胆管造影检查的124例无胆总管结石患者和108例确诊胆总管结石患者的病历。采用Logistic回归分析确定影响胆总管结石发生率的解剖学危险因素。
结果：多因素logistic回归分析显示，几个因素独立地导致胆总管结石的风险。胆总管结石的重要独立危险因素是肝总直径[调整比值比(aOR)=1.43,95%置信区间(CI):1.07-1.92,调整P值=0.016]和胆总管(aOR=1.68,95CI:1.27-2.23,调整P值<0.001),总肝管长度(aOR=0.92,95CI:0.84-0.99,调整后P值=0.034),和胆总管角度（aOR=0.92，95CI：0.89-0.95，校正P值<0.001）。
结论：肝外胆管的解剖特征与胆总管结石的风险直接相关。主要的危险因素包括肝脏和胆管的直径增大，总肝管的长度较短，胆总管的角度缩小了.
目的：探讨胆总管结石患者肝外胆管解剖危险因素。特别关注预防手术干预和内镜碎石术后结石复发。
方法：我们回顾性分析了2022年1月至2022年10月在我们中心接受磁共振胰胆管造影检查的124例无胆总管结石患者和108例确诊胆总管结石患者的病历。采用Logistic回归分析确定影响胆总管结石发生率的解剖学危险因素。
结果：多因素logistic回归分析显示，几个因素独立地导致胆总管结石的风险。胆总管结石的重要独立危险因素是肝总直径[调整比值比(aOR)=1.43,95%置信区间(CI):1.07-1.92,调整P值=0.016]和胆总管(aOR=1.68,95CI:1.27-2.23,调整P值<0.001),总肝管长度(aOR=0.92,95CI:0.84-0.99,调整后P值=0.034),和胆总管角度（aOR=0.92，95CI：0.89-0.95，校正P值<0.001）。
结论：肝外胆管的解剖特征与胆总管结石的风险直接相关。主要的危险因素包括肝脏和胆管的直径增大，总肝管的长度较短，胆总管的角度缩小了.
