Taylor T V, Armstrong C P, Rimmer S, Lucas S B, Jeacock J, Gunn A A
Department of Medical Computation, Manchester University Medical School, UK.
Br J Surg. 1988 Feb;75(2):138-40. doi: 10.1002/bjs.1800750216.
A computerized method, using a small pocket computer, has been used to predict the presence of choledocholithiasis in a prospective series of 239 patients undergoing cholecystectomy. From an initial data base of 424 patients 36 factors were evaluated and the most important 2 of these were determined by multivariate analysis for use in the prospective analysis. Satisfactory operative cholangiograms were a prerequisite to evaluation of the statistical method and were obtained in 90.4 per cent of cases. Using the computerized method a common bile duct stone would have been overlooked in only 1 patient but 17 unnecessary explorations would have been carried out. The overall accuracy of the computerized method was 92.5 per cent. When the method was applied to a further study of 97 patients from a separate centre the overall accuracy was 85.6 per cent. If the method was used to aid selective use of operative cholangiography, cholangiograms would be performed in 20 per cent and stones would be overlooked in less than 1 per cent.
一种使用小型掌上电脑的计算机化方法，已被用于前瞻性地预测239例接受胆囊切除术患者中胆总管结石的存在。在424例患者的初始数据库中，评估了36个因素，并通过多变量分析确定了其中最重要的2个因素，用于前瞻性分析。满意的术中胆管造影是评估统计方法的前提条件，90.4%的病例获得了该造影。使用计算机化方法，只有1例患者的胆总管结石会被漏诊，但会进行17次不必要的探查。计算机化方法的总体准确率为92.5%。当该方法应用于来自另一个中心的97例患者的进一步研究时，总体准确率为85.6%。如果使用该方法辅助选择性地进行术中胆管造影，胆管造影的执行率将为20%，结石漏诊率将低于1%。
