腹腔镜下胆囊切除术中转开腹手术危险因素分析  

Analysis of Risk Factors for Conversion from Laparoscopic Cholecystectomy to Open Surgery

作　　者：谷风华 GU Fenghua(Panjin Hospital of Traditional Chinese Medicine,Panjin 124000,Liaoning Province,China)

机构地区：[1]盘锦市中医医院,辽宁盘锦124000

出　　处：《中国实用乡村医生杂志》2021年第5期47-49,52,共4页Chinese Practical Journal of Rural Doctor

摘　　要：目的探讨腹腔镜下胆囊切除术中转开腹手术的危险因素。方法回顾性收集盘锦市中医医院2013-2020年收治的腹腔镜下胆囊切除术患者423例,依据术中是否中转开腹将纳入患者分为非中转组384例和中转组39例。比较两组患者病史、肝胆系统术前影像学、实验室检查结果及临床表现,分析腹腔镜下胆囊切除术中转开腹手术的危险因素。结果多因素分析显示,在排除腹部手术病史、胆总管直径和谷丙转氨酶的干扰后,胆囊壁增厚、胆囊颈结石、胆总管结石、总胆红素、Murphy征和黄疸,是腹腔镜下胆囊切除术中转开腹手术的危险因素。结论胆囊壁增厚≥5 mm、存在胆囊颈结石和胆总管结石、总胆红素>17.1 μmol/L、Murphy征和黄疸阳性的患者,在行腹腔镜下胆囊切除术时,中转开腹手术的风险增加。Objective To investigate the risk factors of conversion from laparoscopic cholecystectomy(LC)to laparotomy.Methods A total of 423 LC patients in Panjin Hospital of Traditional Chinese Medicine from 2013 to 2020 were retrospectively collected.According to whether they were converted to laparotomy or not,they were divided into non conversion group and conversion group with 39 cases in each group.The medical history,preoperative imaging of the hepatobiliary system,laboratory examination results and clinical manifestations of the two groups were compared,the risk factors of LC converting to open surgery were analyzed.Results Excluding the interference of the history of abdominal surgery,the diameter of common bile duct and ALT,the multivariate analysis showed that gallbladder wall thickening,gallbladder neck stones,common bile duct stones,TBil,Murphy sign and jaundice were risk factors for conversion to open surgery during LC.Conclusion The risk of conversion to open surgery during LC is significantly increased in patients with gallbladder wall thickening≥5 mm,gallbladder neck stones and common bile duct stones,TBIL>17.1μmol/L,Murphy sign and jaundice positive.

关 键 词：胆囊切除术 腹腔镜 中转开腹 危险因素 分析 

分 类 号：R656[医药卫生—外科学]