Analysis of factors affecting preoperative Oddi sphincter function in patients with common bile duct stones
10.3760/cma.j.cn113884-20240923-00284
- VernacularTitle:胆总管结石患者胆总管探查术前Oddi括约肌功能影响因素分析
- Author:
Haichuan CHEN
1
;
Zhejin WANG
1
;
Hongliang SONG
1
Author Information
1. 温州市中心医院肝胆外科，温州 325000
- Publication Type:Journal Article
- Keywords:
Choledocholithiasis;
Sphincter of Oddi;
Endoscopic retrograde cholangiopancreatography
- From:
Chinese Journal of Hepatobiliary Surgery
2025;31(7):529-533
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the factors affecting the laxity of Oddi sphincter in patients with common bile duct stones prior to common bile duct exploration.Methods:Clinical data of 101 patients with common bile duct stones undergoing common bile duct exploration at Wenzhou Central Hospital from January 2020 to June 2024 were retrospectively analyzed, including 38 males and 63 females, aged (68.6±13.3) years. All patients underwent common bile duct exploration with choledochoscopy. The size, shape, and patency of the papillary opening at the lower end of Oddi sphincter were observed to classify the sphincter function into Grades 1 to 4. The morphology of the papillary opening at the lower end of common bile duct was defined as narrowed, normal, oversized, and relaxed, respectively. Univariate and multivariate logistic regression analysis were conducted to identify the influencing factors of the laxity of Oddi sphincter.Results:Among the 101 patients, there were two cases (2.0%) classified as Grade 1 of Oddi sphincter function, 40 (39.6%) classified as Grade 2, 43 (42.6%) classified as Grade 3, and 16 (15.8%) classified as Grade 4. Under choledochoscopy, the Oddi sphincter function was classified into Grades 1 to 3 (stenosis, normal and oversized, included in the control group, n=85). Grade 4 was included in the laxity group ( n=16). The proportion of endoscopic retrograde cholangiopancreatography (ERCP) history, preoperative level of alanine aminotransferase, preoperative common bile duct diameter, preoperative maximum diameter of common bile duct stones, and preoperative bile duct gas accumulation in the laxity group were all higher than those in the control group (all P<0.05). Multivariate logistic regression analysis showed that patients with larger preoperative common bile duct diameter ( OR=12.993, 95% CI: 1.913-88.263), larger preoperative maximum diameter of common bile duct stones ( OR=6.238, 95% CI: 1.266-30.730), and a history of ERCP ( OR=8.119, 95% CI: 1.125-58.584) had a higher risk of preoperative Oddi sphincter laxity (all P<0.05). Conclusion:History of ERCP, diameter of common bile duct, and maximum diameter of common bile duct stones are risk factors for the laxity of Oddi sphincter prior to common bile duct exploration in patients with common bile duct stones.
