胆囊结石; 胆囊炎,急性; 胆囊切除术,腹腔镜; 难易程度判定; 因素分析," /> 胆囊结石; 胆囊炎,急性; 胆囊切除术,腹腔镜; 难易程度判定; 因素分析,"/> Cholecystolithiasis,Cholecystitis, Acute,Cholecystectomy, Laparoscopic,Assessment of the difficulty or simplify,Factor Analysis,"/> <font face="Verdana">急性结石性胆囊炎行LC术难易程度的相关因素分析

中国普通外科杂志 ›› 2009, Vol. 18 ›› Issue (8): 782-785.

• 胆道微创外科专题研究 • 上一篇    下一篇

急性结石性胆囊炎行LC术难易程度的相关因素分析

李军| 张辉| 朱雷鸣| 丁峻岭   

  1. (上海市长宁区中心医院 肝胆外科| 上海 200336)
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2009-08-15
  • 通讯作者: 李军 E-mail:upinarm@tom.com

Factors related with difficulty of LC in acute calculus cholecystitis

LI Jun, ZHANG Hui, ZHU Leiming, DING Junling   

  1. (Department of General Surgery, Changning Distract Central Hospital, Shanghai 200336,China)
  • Received:1900-01-01 Revised:1900-01-01 Online:2009-08-15

摘要:

目的:探讨急性结石性胆囊炎行LC(Laparoscopic Cholecystectomy,LC)手术难易程度的相关因素。
方法:将245例急性结石性胆囊炎患者根据手术时间和有无中转分成容易组(123例)和困难组(122例)(含中转开腹组33例 open cholecystectomy, OC),分别比较各组术前一般资料、术前影像学差异和腹腔镜下所见,筛选出有统计学差异的指标。
结果:术前资料中,容易组和困难组在体温、白细胞计数,手术时机、胆囊壁厚度、胆囊体积、胆总管直径各指标间差异有统计学意义(均P<0.05);术中镜下所见,两组在胆囊壁厚度、大小、颈部结石嵌顿、胆总管直径、胆囊三角各指标间差异均有统计学意义(均P<0.01)。
结论:急性结石性胆囊炎体温升高,白细胞计数增加,胆囊壁增厚、胆囊体积增大、胆总管直径大于8 mm、颈部结石嵌顿、Calot三角不清是行LC困难的因素。

关键词: 牛坚, 刘细平, 王维冬, 李向农, 钟德玝, 龚长军, 韩泽广, 林辉, 胆囊结石; 胆囊炎')">胆囊结石; 胆囊炎, 急性; 胆囊切除术, 腹腔镜; 难易程度判定; 因素分析

Abstract:

ObjectiveTo explore the factors related with difficulty of laparoscopic cholecystectomy (LC) for acute calculus cholecystitis.
MethodsA total of 245 patients were retrospectively divided into two groups: easy group(123patients)and difficult group(122patients, including 32patients of conversion to OC )based on surgery time and LC or OC.
ResultsThere were statistical differences between the groups in regards to preoperative body temperature, white blood cell count, surgical timing, the thickness of gallbladder wall, gallbladder volume, and diameter of common bile duct (all P<0.05); and there were obvious statistical differences between the 2 groups in thickness of gallbladder wall, gallbladder volume, diameter of common bile duct, stone impaction in the neck of gallbladder,and the condition of Calot′s triangle during operation (all P<0.01).
ConclusionsFactors related to difficulty of LC in acute calculus cholecystitis include elevated body temperature,increased white blood cell count,thickened gallbladder wall,increased gallbladder volume,common bile duct diameter more than 8 mm,stone impaction in neck of gallbladder and unclear anatomy of Calot′s triangle.

Key words: NIUJian, LIUXi-ping, LIXiang-Nong, ZHONGDe-wu, HANZe-Guang, LINHui, Cholecystolithiasis')">Cholecystolithiasis, Cholecystitis, Acute, Cholecystectomy, Laparoscopic, Assessment of the difficulty or simplify, Factor Analysis

中图分类号: 

  • R 657.4
[1] 于爱军1|赵洪涛1|赵鲁文2|史华宁3|张学军1|刘金龙1. 急性胆囊炎术前超声征象与腹腔镜胆囊切除术转开腹的关系[J]. 中国普通外科杂志, 2011, 20(2): 143-145.
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