急诊腹腔镜胆囊切除术中转开腹手术的危险因素分析及防范  

Risk factors for conversion to laparotomy in emergent laparoscopic cholecystectomy

作　　者：程凯[1] 周少波[1] 贲大刚[1] 褚亮[1] 蒋磊[1] 

机构地区：[1]蚌埠医学院第二附属医院普外科,安徽蚌埠233040

出　　处：《蚌埠医学院学报》2011年第12期1333-1335,共3页Journal of Bengbu Medical College

摘　　要：目的:探讨急诊腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)中转开腹的危险因素及避免中转开腹的措施。方法:对112例急性胆囊炎患者行急诊LC,并对临床资料进行单因素分析。结果:103例成功完成LC,9例中转开腹。急诊LC成功患者的胆囊壁厚度、急性胆囊炎的发作次数、上腹部手术史、胆囊管结石嵌顿和丙氨酸氨基转移酶与9例中转开腹患者比较,差异有统计学意义(P<0.05～P<0.01)。结论:胆囊壁厚度、上腹部手术史、急性胆囊炎发作次数(>3次)、胆囊管结石嵌顿和丙氨酸氨基转移酶升高等是中转开腹的危险因素;仔细分析危险因素,掌握操作技巧是降低并发症和中转开腹率的有效措施。Objective：To explore the risk factors and preventive measures for conversion to open cholecystectomy in emergent laparoscopic cholecystectomy（LC）.Methods： The clinical data of 103 cases of LC were performed single factor analysis and multiple factor analysis with logistic regression;and the independent risk factors affecting the conversion of LC to laparotomy were concluded.Results：The operation was successfully performed in 103 cases,and 9 cases were converted to open surgery.The analysis revealed that the risk factors included thickened gallbladder wall,times of cholecystitis attacks,history of upper abdominal operation,cystic duct calculus incarceration and ALT（P0.05 to P0.01）.Conclusions：The risk factors of conversion to open cholecystectomy include thickened gallbladder wall,history of upper abdominal operation,times of acute cholecystitis attacks（3 times）,stone incarceration on the neck of gallbladder and ALT levels.Analysis of the risk factors and master the operative skills is efective method to reduce the rate of complications and conversion to laparotomy.

关 键 词：胆囊炎 腹腔镜 胆囊切除术 中转开腹手术 

分 类 号：R657.41[医药卫生—外科学]