胆囊结石合并急性胰腺炎胆囊切除术治疗患者中转开腹率及风险因素分析  

Analysis of rate of conversion to laparotomy and risk factors in patients with cholecystolithiasis complicated with acute pancreatitis undergoing cholecystectomy

作　　者：陈诚 Chen Cheng(Department of Surgery,Ruichang Traditional Chinese Medicine Hospital,Jiujiang 332200,Jiangxi,China)

机构地区：[1]瑞昌市中医医院外科,江西九江332200

出　　处：《四川生理科学杂志》2025年第3期688-690,共3页

摘　　要：目的:探究胆囊结石合并急性胰腺炎(Acute pancreatitis,AP)患者腹腔镜胆囊切除术(Laparoscopic Cholecystectomy,LC)中转开腹率及其影响因素。方法:回顾性收集2019年2月~2024年9月在本院接受LC治疗的67例胆囊结石合并AP患者的病历资料,调查患者中转开腹率;根据是否中转开腹将患者分为中转开腹组(n=7)和对照组(n=60),比较两组临床资料,采用Logistic回归分析影响胆囊结石合并AP患者LC中转开腹的危险因素。结果:本研究67例接受LC治疗的胆囊结石合并AP患者中有7例中转开腹,中转开腹率为10.45%;中转开腹组患者胆囊壁厚度大于对照组(P<0.05);中转开腹组患者白细胞计数和降钙素原水平均高于对照组(P<0.05);Logistic回归分析结果显示:高胆囊壁厚度、白细胞计数、降钙素原均是胆囊结石合并AP患者LC中转开腹的独立危险因素(P<0.05)。结论:胆囊结石合并AP患者LC中转开腹率较高,且患者中转开腹率与胆囊壁厚度和炎症反应程度密切相关。Objective:To investigate the rate of conversion of laparoscopic cholecystectomy(LC)to laparotomy and its influencing factors in patients with cholecystolithiasis complicated with acute pancreatitis(AP).Methods:The medical records of 67 patients with cholecystolithiasis complicated with AP who received LC in the hospital from February 2019 to September 2024 were retrospectively collected,and the rate of conversion to laparotomy was investigated.The patients were divided into laparotomy group(n=7)and control group(n=60)according to whether conversion to laparotomy occurred.The clinical data were compared between groups,and Logistic regression analysis was applied to analyze the risk factors of conversion of LC to laparotomy in cholecystolithiasis with AP.Results:In this study,7 cases were converted to laparotomy among 67 patients with cholecystolithiasis and AP who received LC,and the rate of conversion to laparotomy was 10.45%.The thickness of gallbladder wall in conversion group was thicker than that in control group(P<0.05).The white blood cell count and procalcitonin were higher in conversion group than those in control group(P<0.05).Logistic regression analysis showed that high gallbladder wall thickness,white blood cell count and procalcitonin were independent risk factors for conversion of LC to laparotomy(P<0.05).Conclusion:The conversion rate of LC to laparotomy is high in patients with cholecystolithiasis and AP,and the rate of conversion to laparotomy is closely related to the thickness of gallbladder wall and the degree of inflammatory response.

关 键 词：胆囊结石 急性胰腺炎 腹腔镜胆囊切除术 中转开腹 影响因素 

分 类 号：R65[医药卫生—外科学]