目的    探讨十二指肠镜乳头括约肌切开术（endoscopic sphincterotomy，EST）后胆管结石复发的相关风险因素。方法    回顾性分析天津市南开医院2000年6月至2002年9月1971例因胆管结石行EST术病人的临床资料，以EST术后是否复发胆管结石为因变量，进行单因素及多因素非条件Logistic逐步回归分析。结果    EST术后1616例获得确切随访，其中181例胆管结石复发，复发率为11.2%, 通过统计学单因素及多因素分析显示胆囊状态、胆道积气、壶腹憩室、行碎石术与EST术后胆管结石复发有关。结论    纠正或避免胆道积气、壶腹憩室等风险因素对预防胆管结石的复发有重要意义。

Risk factors for recurrent bile duct stones after endoscopic sphincterotomy        DING Guo-qian, QIN Ming-fang, WANG Qing，et al. Minimally Invasive Surgery Center of Tianjin Nankai Hospital, Tianjin 300100，China
Corresponding author: QIN Ming-fang, E-mail:qins88@sian.com
Abstract    Objective    To analyze the risk factors for recurrent bile duct stones after endoscopic sphincterotomy (EST). Methods    The clinical data of 1971 consecutive patients who underwent EST for bile duct stones from June 2000 to September 2002 were analyzed retrospectively．Single factor analysis was performed on the related risk factors，and the statistic significant difference was re-introduced by non-conditional logistic regression model for multivariate analysis．Results    Follow up was definited in 1616 patients after EST. Recurrence of bile duct stones occurred in 181 patients with the recurrence rate of 11.2%. Single factor analysis and multi-factor logistic regression analysis showed that the recurrence of bile duct stones is related to gall bladder status，diverticula　ampullae，lithotripsy and pneumobilia. Conclusion    Management or prevention of gall bladder status, diverticula ampullae, lithotripsy and pneumobilia were significant for the prevention of recurrent bile duct stones.