Tan Hao-Yang, Gong Jun-Fei, Tang Wen-Hao, Li Peizhi, Yang Kang
Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Hematology and Oncology, The Children's Hospital of Chongqing Medical University, Chongqing, China.
J Laparoendosc Adv Surg Tech A. 2019 Sep;29(9):1116-1121. doi: 10.1089/lap.2019.0170. Epub 2019 Jul 18.
This study was aimed to evaluate the correlation between clinically significant portal hypertension (CSPH) and postoperative complications and risk predictors of postoperative complications. The retrospective study was conducted to identify the effect. The cirrhotic patients were divided into two groups, those with or without CSPH. The intraoperative and postoperative conditions were evaluated. Multivariate logistic regression analysis was performed to identify potential risk predictors for postoperative complications in cirrhotic patients with CSPH. The cirrhotic patients with CSPH who underwent laparoscopic cholecystectomy (LC) had postoperative hospitalization than the patients without CSPH. However, the incidence of postoperative complications between two groups showed no significant difference. The results of multivariate analysis showed that male, gallbladder wall >3 mm, size of stones ≥1 cm, scores of Model for end-stage liver disease (MELD) ≥10, and operation time >60 minutes were the potential risk predictors for postoperative complications. CSPH did not increase the incidence of postoperative complications in cirrhotic patients who underwent LC, but increased conversion rate and prolonged postoperative hospitalization. Furthermore, our study showed that gender, sizes of gallbladder wall and stones, scores of MELD, and operation time were the important postoperative risk predictors for cirrhotic patients with CSPH.
本研究旨在评估临床显著性门静脉高压(CSPH)与术后并发症之间的相关性以及术后并发症的风险预测因素。进行了一项回顾性研究以确定其影响。肝硬化患者被分为两组,即有或无CSPH的患者。对术中及术后情况进行评估。进行多因素逻辑回归分析以确定CSPH肝硬化患者术后并发症的潜在风险预测因素。接受腹腔镜胆囊切除术(LC)的CSPH肝硬化患者术后住院时间比无CSPH的患者长。然而,两组术后并发症的发生率无显著差异。多因素分析结果显示,男性、胆囊壁>3mm、结石大小≥1cm、终末期肝病模型(MELD)评分≥10以及手术时间>60分钟是术后并发症的潜在风险预测因素。CSPH并未增加接受LC的肝硬化患者术后并发症的发生率,但增加了中转率并延长了术后住院时间。此外,我们的研究表明,性别、胆囊壁和结石大小、MELD评分以及手术时间是CSPH肝硬化患者重要的术后风险预测因素。