难单切口腹腔镜胆囊切除术的影像学预测因素

A. Chaudhary, R. Chauhan, R. Jhobta
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摘要

背景:单切口腹腔镜胆囊切除术(SILC)通过减少切口数量来进一步减少腹腔镜胆囊切除术的侵入性。术前临床因素的知识,以预测困难的SILC可用于术前咨询患者关于手术的成功结果,以及预测术前转换的风险为选定的患者,做好心理准备,并尽量减少手术相关的成本。目的:探讨难治性SILC的影像学预测因素。方法:本研究是一项以医院为基础的前瞻性观察研究,纳入50例因胆结石疾病行择期腹腔镜胆囊切除术的患者。采用多元logistic回归分析预测单切口腹腔镜胆囊切除术的难度。结果:50例患者中,有15例患者行难解性SILC, 35例患者行简单单切口腹腔镜胆囊切除术,多因素logistic回归分析难解性SILC的独立危险因素为:超声显示胆囊收缩或膨胀,MRI显示脐到Calot三角距离(UCD)较长。结论:超声显示难辨性SILC胆囊收缩或扩张,MRI显示脐至Calot三角距离变长与影像学因素有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Radiological Predictors for Difficult Single Incision Laparoscopic Cholecystectomy
Background: Single-incision laparoscopic cholecystectomy (SILC) has been developed to further minimize the invasiveness of laparoscopic cholecystectomy by reducing the number of incisions. Knowledge of preoperative clinical factors to predict difficult SILC may be used for the preoperative counselling of the patients regarding the successful outcome of the surgery as well as to predict the risk of conversion preoperatively for selected patients, prepare the patient psychologically and minimise the procedure related cost. Objective: The present study was conducted to know about radiological predictors for difficult SILC. Methods: The study was a hospital based prospective observational study where 50 patients undergoing elective laparoscopic cholecystectomy due to gall stone diseases were included in the study. Multiple logistic regression analysis was done to predict difficult single incision laparoscopic cholecystectomy. Results: Out of 50 patients 15 patients underwent difficult SILC, while 35 patients had undergone easy single incision laparoscopic cholecystectomy independent risk factors in multivariate logistic regression analysis for difficult SILC were: contracted or distended gall bladder on ultrasound, longer umbilicus to Calot’s triangle distance (UCD) on MRI. Conclusion: Radiological Factors associated with difficult SILC contracted or distended gall bladder on ultrasound and longer umbilicus to Calot’s triangle distance on MRI.
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