Kaneko Tadashi, Kuwahara Taichi, Harada Toshio, Kawaoka Toru, Hiraki Sakurao, Fukuda Shintaro
Department of Surgery Ube Industries Ltd. Central Hospital Ube Yamaguchi Japan.
Acute Med Surg. 2015 Jan 8;2(3):190-194. doi: 10.1002/ams2.99. eCollection 2015 Jul.
Laparoscopic cholecystectomy is frequently used to treat low-grade acute cholecystitis. Improvements in technical skills have reduced the rate of conversion from laparoscopic to open surgery. In this study, we sought to identify factors that might predict the surgical time of laparoscopic cholecystectomy as possible markers for surgical difficulty.
We carried out a single-center retrospective analysis of a Japanese medical insurance database. Data were retrieved for 87 patients with acute cholecystitis. The analyzed factors included age, sex, body mass index, medical history, blood laboratory data, computed tomography findings, and time from disease onset to surgery. Multiple regression analysis was used to identify factors associated with surgical time.
Edema of the gallbladder wall on computed tomography, neutrophil sequestration, body mass index, and history of acute cholangitis were significantly associated with surgical time ( = 0.014, 0.027, 0.043, and 0.047, respectively). The conversion rate from laparoscopic surgery to open surgery was 2%.
Our results suggest that edema of the gallbladder wall on computed tomography, neutrophil sequestration, body mass index, and history of acute cholangitis are associated with surgical time of laparoscopic cholecystectomy in the treatment of acute cholecystitis in our hospital.
腹腔镜胆囊切除术常用于治疗轻度急性胆囊炎。技术水平的提高降低了腹腔镜手术转为开腹手术的比例。在本研究中，我们试图确定可能预测腹腔镜胆囊切除术手术时间的因素，将其作为手术难度的潜在指标。
我们对一个日本医疗保险数据库进行了单中心回顾性分析。检索了87例急性胆囊炎患者的数据。分析的因素包括年龄、性别、体重指数、病史、血液实验室数据、计算机断层扫描结果以及从发病到手术的时间。采用多元回归分析确定与手术时间相关的因素。
计算机断层扫描显示的胆囊壁水肿、中性粒细胞隔离、体重指数和急性胆管炎病史与手术时间显著相关（分别为P = 0.014、0.027、0.043和0.047）。腹腔镜手术转为开腹手术的比例为2%。
我们的结果表明，在我院治疗急性胆囊炎时，计算机断层扫描显示的胆囊壁水肿、中性粒细胞隔离、体重指数和急性胆管炎病史与腹腔镜胆囊切除术的手术时间相关。
