术前超声对腹腔镜胆囊切除术手术难度的预测价值

Predictive Value of Preoperative Ultrasonography on the Difficulty of Laparoscopic Cholecystectomy

目的探讨术前超声对腹腔镜胆囊切除术手术难度的预测价值。方法依据切除手术难度评分和分级标准,将100例行腹腔镜胆囊切除术患者分为容易组和困难组,比较超声诊断结果同实际手术难度程度的符合率。结果 (1)术前超声诊断的准确率高达96.3%;(2)胆囊壁厚度≥4 mm、结石直径过大、有胆囊颈部结石嵌顿,胆囊>12 cm×4 cm、有胆囊底粘连和有胆囊颈粘连是导致腹腔镜胆囊切除术难度提高的危险因素(P均<0.05)。结论术前超声对腹腔镜胆囊切除术手术难度具有较高的预测价值,术前诊断发现致手术难度提高危险因素,当提前做好准备,规避风险。

Objective To explore the predictive value of preoperative ultrasonography on the difficulty of laparoscopic cholecystectomy. Methods 100 cases of laparoscopic cholecystectomy were divided into easy group and difficulty group according to difficulty score and classification standard of laparoscopic cholecystectomy,compared the ultrasound diagnosis results with actual operation difficulty degree of coincidence rate,and then analyzed and summaried the risk factors for the difficulty of laparoscopic cholecystectomy by Logistic single factors analysis.Results The accuracy rate of preoperative diagnosis was 96. 3%; The gallbladder wall thickness was greater than or equal to 4mm,stone diameter was too large,there were stones in the gallbladder neck incarcerated,gallbladder was greater than 12 cm × 4cm,a base of gallbladder adhesion and gallbladder cervical adhesion were the results of laparoscopic cholecystectomy and the risk factors of surgical difficulty raising( P < 0. 05). Conclusion Preoperative ultrasound is high predictive value for laparoscopic cholecystectomy,and preoperative diagnosis is difficult to improve the risk factors.