胆囊造影预测腹腔镜胆囊切除术的可行性

The prediction of cholecystography for the possibility of laparoscopic cholecystectomy (LC)

目的 :评价胆囊造影预测腹腔镜胆囊切除术 (LC)可行性的价值。方法 :回顾分析 2 0 0例胆囊疾病胆囊造影的结果 ,预测LC的可行性并与手术结果比较。结果 :14 9例胆囊显影 ,其中 6例提示胆管结石 ,5 1例胆囊不显影 ;194例选择LC ,183例完成LC手术 ,中转开腹 11例 ,其中 2例胆囊显影 ,9例胆囊不显影。胆囊造影预测LC可行性的准确度为 77%,灵敏度为 77%,特异度为 82 %,误诊率为 18%,漏诊率为 2 3%,尤登指数为 0 5 9,阳性预告值为 99%,阴性预告值为 18%。结论 :胆囊造影检查可提高胆管疾病诊断率 ,并能指导手术。初期开展LC的单位 。

Objective:To study the value of cholecystography in the prediction of the possibility of laparoscopic cholecystectomy (LC).Methods:The clinical data of 200 cases with cholecystic disease examined by cholecystography were retrospectively analyzed. Results: 149 cases had cholecyst developed, 6 of them had cholangiolith, 51 cases had no developed. 194 cases were selected LC, and 183 cases completed, the other 11 were converted to open cholecystectomy. 2 of the 11 had cholecyst developed, 9 cases had no developed. By cholecystography to predict the possibility of LC, the accuracy rate was 77%, the sensibility rate sas 77%, the differential rate was 82%, the misdiagnosis rate was 18%, the missed diagnosed rate was 23%, the Youden's index was 0.59, the positive prediction value was 99%, and the negative prediction rate was 18%. Conclusions:Cholecystography can improve the diagnosis rate of cholangiolith, and instruct for operation.