B超预测急性胆囊炎行腹腔镜胆囊切除术难度的价值

Preoperative ultrasonography to predict laparoscopic cholecystectomy difficulty for acute cholecystitis patients

目的 :评价术前B超预测腹腔镜胆囊切除术 (LC)的难度。方法 :收集 140例急性胆囊炎行腹腔镜切除术患者术前 8hB超及手术的详细资料 ,以B超中各参数为自变量 ,手术难度记分为因变量 ,采用多元回归分析法 ,评估术前B超对腹腔镜胆囊切除术难度预测作用。结果 :胆囊壁厚度与LC的难度呈正相关 ,胆囊管长度与LC的难度呈负相关。结论

Objective:To evaluate the value of preoperative ultrasound findings for predicting possible difficulties encountered during laparoscopic cholecystectomy(LC).Methods:140 patients with acute cholecystitis,all underwent ultrasound examination 8 hours prior to LC.The overall difficulty score(ODS),as dependent variable,was based on the following operative parameters:duration of surgery,bleeding the dissection fo Calot's triangle,dissection of gallbladder(GB) wall,spillage of bile and difficulty of gallbladder extraction.Multiple regression analysis was used to assess the significant of the following preoperative ultrasound variable (independent) for predicting the variation in the ODS:size of the GB,number of GB stones,size of stones,location of GB stones,thickness of GB wall,and length of cystic duct.Results:Only thickness of GB wall and length of cystic duct were found to be the significant prediction of the variation in the ODS.Conclusion:Preoperative ultrasonography is valuable for predicting difficuties during LC.