腹腔镜胆囊切除术转开腹手术的危险因素分析

The risk factors of laparoscopic cholecystectomy conversion to open cholecystectomy

目的研究多个临床因素对腹腔镜胆囊切除术(LC)转开腹手术的影响。方法对浙江大学医学院附属邵逸夫医院1994年4月至2001年6月的7134例LC的临床资料进行单因素分析,再进行多元逻辑回归分析(逐步排除法),得出影响LC转开腹手术的独立的危险因素。结果男性、高龄(≥65岁)、上腹部手术史、糖尿病、总胆红素升高(≥20.5μmol/L)、胆囊壁增厚(≥4mm)、胆总管直径增宽(≥8mm)、急性胆囊炎是转开腹手术的危险因素。结论可以根据转开腹手术的危险因素指导临床工作。

Objective To study the impact of multiple clinical factors on laparoseopie eholeeysteetomy conversion to open cholecystectomy. Methods Single factor analysis was performed for the clinical factors of the 7134 cases of LC that Sir Run Run Shaw Hospital of Zhejiang University Medical College had received from April 1994 to June 2001. Multiple factor analysis with logistic regression was performed for the risk factors. The independent risk factors that affect the conversion rate were selected, Results Male, 1〉65,upper abdominal operation history,diabetes, high lever of total bilirubin （≥20. 5μmoL/L）,thickened Wall of gallbladder（≥4mm）, dilated diameter of common bile duct（≥8mm） and acute cholecystitis were independent risk factors. Conclusion Risk factors of laparoscopic cholecystectomy conversion to open cholecystectomy can be used to direct clinical works.