预测腹腔镜胆囊切除术困难的术前临床和影像学指标

Q4 Medicine
S. Elgarf, Tamer M. Elmahdy, M. Ghazaly, A. Swelam
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引用次数: 0

摘要

腹腔镜胆囊切除术(LC)已取代开放技术成为治疗胆囊结石的主要手术干预手段。有不同的临床和放射学预测指标是技术上困难的LC的指标。工作目的:本研究的目的是确定与难治性LC相关的临床和放射学变量。方法:2018年3月至2021年3月,452例出现症状性胆囊结石的成年患者行LC。收集不同的临床和影像学资料,如:腹部疤痕、可触及的胆囊、既往住院、ERCP史、白细胞总数、胆囊壁厚度、胆囊周围收集、单发或多发胆囊结石、嵌塞结石和CBD直径。结果:50岁及以上(P值0.001)、男性(P值0.001)、既往住院史(P值0.001)、嵌塞结石(P值0.003)、白细胞增多(P值0.031)的差异有统计学意义,ROC曲线下面积为0.814,可信区间为95%。结论:术前危险因素;老年、男性、既往因胆道问题住院、嵌塞结石和白细胞增多可能预测难治性LC,使外科医生及其助手有机会预测术中并发症的风险,并有可能将手术转为救助手术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Preoperative Clinical and Radiological Variables for Prediction of Difficult Laparoscopic Cholecystectomy
Introduction: Laparoscopic cholecystectomy (LC) has replaced open technique as the main surgical intervention in the treatment of gall bladder stones. There are different clinical and radiological predictors that are indicators for technically difficult LC. Aim of the work: The aim of this study was to identify the clinical and radiological variables associated with difficult LC. Methods: During the period from March 2018 to March 2021, 452 adult patients who presented with symptomatic gall bladder stones underwent LC. Different clinical and radiological data were collected as: abdominal scar, palpable gall bladder, previous hospitalization, history of ERCP, total leucocyte count, thickness of the gall bladder wall, peri-cholecystic collection, solitary or multiple gall bladder stones, impacted stone and diameter of the CBD. Results: Age of 50 years or over (P value 0.001), male gender (P value 0.001), previous hospital admission (P value 0.001), impacted stones (P value 0.003), and leukocytosis (P value 0.031) were found statistically significant with area under ROC curve is 0.814 with 95 % confidence interval. Conclusion: These preoperative risk factors; old age, male gender, previous hospitalization for biliary problem, impacted stone, and leukocytosis could potentially predict difficult LC, and give surgeons and their assistants the chance to predict the risk of complications intraoperatively and the possibility to convert the maneuver to a bail-out one.
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来源期刊
Surgery, Gastroenterology and Oncology
Surgery, Gastroenterology and Oncology Medicine-Gastroenterology
CiteScore
0.30
自引率
0.00%
发文量
11
期刊介绍: Starting with this issue "Annals of Fundeni Hospital", founded in 1996 as the scientific journal of the prestigious hospital Fundeni becomes "Journal of Translational Medicine and Research" (JTMR), an Journal of the Academy of Medical Sciences of Romania. Therefore, an 18 years old Journal, attested and indexed in Elsevier Bibliographic Databases, Amsterdam and also indexed in SCOPUS, is continuing a tradition of excellence that lasted almost two decades. The new title of the Journal is inspired first of all from the important developments of translational research In Fundeni Clinical Institute and the "C.C Iliescu Institute for Cardio-Vascular Diseases", in parallel with the national and international trend to promote and develop this important area or medical research. Although devoted mainly to translational research, JTMR will continue to promote both basic and clinical research.
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