使用临床和超声参数对困难腹腔镜胆囊切除术进行术前预测。
Pre-operative prediction of difficult laparoscopic cholecystectomy using clinical and ultrasonographic parameters.
作者信息
Nachnani Jagdish, Supe Avinash
机构信息
Department of Surgical Gastroenterology, Seth G S Medical College and K E M Hospital, Mumbai-400 012, India.
出版信息
Indian J Gastroenterol. 2005 Jan-Feb;24(1):16-8.
BACKGROUND
Pre-operative prediction of a difficult laparoscopic cholecystectomy (LC) can help the patient as well as the surgeon prepare better for the intra-operative risk and the risk of conversion to open cholecystectomy.
METHODS
In 105 eligible patients who underwent LC during May 2001 to January 2003, patient characteristics, clinical history, laboratory data, ultrasonography results and intra-operative details were prospectively analyzed to determine predictors of difficult LC.
RESULTS
Of 105 patients, 12 (11.4%) required conversion to open cholecystectomy. Significant predictors of conversion were body mass index> 30 Kg/m2, male gender, past history of acute cholecystitis or acute pancreatitis, past history of upper abdominal surgery, and gall bladder wall thickness exceeding 3 mm.
CONCLUSION
Clinical and ultrasonograpic factors can help predict difficult LC and likelihood of conversion of LC to open surgery.
背景
术前预测困难的腹腔镜胆囊切除术（LC）有助于患者和外科医生更好地为术中风险以及转为开腹胆囊切除术的风险做好准备。
方法
对2001年5月至2003年1月期间接受LC的105例符合条件的患者，前瞻性分析患者特征、临床病史、实验室数据、超声检查结果及术中细节，以确定困难LC的预测因素。
结果
105例患者中，12例（11.4%）需要转为开腹胆囊切除术。转为开腹手术的显著预测因素为体重指数>30 Kg/m²、男性、既往急性胆囊炎或急性胰腺炎病史、既往上腹部手术史以及胆囊壁厚度超过3 mm。
结论
临床和超声因素有助于预测困难的LC以及LC转为开腹手术的可能性。
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