腹腔镜胆囊切除术中转手术相关因素评估

Related Factors for Conversion to Open Surgery in Patients Undergoing Laparoscopic Cholecystectomy

目的探讨腹腔镜胆囊切除术中转手术的相关因素。方法分析1994-12～2009-12间,我院对有症状性胆囊结石患者所做腹腔镜胆囊切除术5 221例病历资料。其中,中转手术272例。本文旨在比较中转手术和非中转手术组患者,在年龄、性别、体重指数、急性炎症、既往上腹部手术史、术前合并症、术前辅助检查、手术时间、术后住院时间和术后并发症等方面的差别,找出与中转手术相关的因素。结果两组患者在年龄、性别、体重指数、急性炎症、既往手术史、术前白细胞计数、手术时间、术后住院时间和术后并发症等方面有显著差异(P<0.05),在术前血胆红素和谷丙转氨酶水平以及术前合并症方面无差异(P>0.05)。结论高龄、男性、肥胖、急性炎症、既往有上腹部手术史、术前白细胞增高,是中转手术的高危因素。中转手术的患者手术时间和术后住院时间延长,术后并发症发生率增高。

Objective To explored the related factors for comversion to open surgery in patients undergoing laparoscopic cholecystectomy.Methods To retrospectively review and analyze the 5 221 patients with symptomed gallstones diseases undergoing laparoscopic cholecystectomy from Dec 1994 to Dec 2009.Among them 272 patients had to convert to open surgery and were put into Conversion group,and the others were into LC group.The age、sex、BMI、acute inflammation、the white cells count、upper operation history、operative times,postoperative complications 、hospital stay times and other factors were compared between two groups.Results Two groups have significant differences in age、sex、BMI、acute inflammation、the white cells count、upper operation history、operative times,postoperative complications and hospital stay times,while no differences in the levels of total bilirubin and aspartate transaminase,and Presence of chronic liver disease and diabetes mellitus.Conclusion Some factors are related to the ratio of conversion to open surgery,and it will be helpful for surgeons and patients with the availability of such information.