摘要
目的探讨术前对腹腔镜胆囊切除术(LC)难度进行评估的方法。方法回顾性分析2005年6月至2011年8月460例LC的术前临床资料、手术难度,制定LC难易程度的标准,根据标准将460例患者分为容易组、困难组、极困难组,对比分析各组手术时间、中转开腹率及并发症发生率。结果容易组398例,手术时间18～38 min,无中转开腹病例,并发症发生率0.25%;困难组49例,手术时间35～78 min,中转率2%,并发症发生率4%;极困难组13例,手术时间65～123 min,中转率7.69%,并发症发生率7.69%。结论影响LC手术难度的因素是多方面的,根据术前的临床资料按此标准进行评估分组是可靠可行的,有助于术者根据自己实际腹腔镜技术水平选择相应的手术适应证,提高手术成功率,减少中转开腹及严重并发症的发生。
Objective To explore the appropriate preoperative methods to evaluate the difficulty of laparoscopic cholecystectomy （LC）. Methods All 460 cases underwent LC from June 2005 to August 2011, and the preoperative clinical data and LC operation difficulty were retrospectively analyzed. According to the degree of operation difficulty, all of 460 cases were divided into easy group, difficult group, and extremely difficult group, then the operation time, the rate of transit open operation and complications among the three groups were com- pared. Results In easy group （ n = 398 ）, the operation time was 18 ~ 38 minutes, the complication rate was 0.25 % , and no case was un- dergone transit open operation. In difficult group （n = 49 ） , the operation time was 35 to 78 minutes, the complication rate was 4% and 2% of them performed the transit open operation. In the very difficult group （n = 13 ）, the operation time was 65 ~ 123 minutes, the complica- tion rate was 7.69% and the transit open operation rate was 7.69%. Conclusion Multiple factors affect the operation difficulty of LC. It might he feasible to divide patients in different groups according to the degree of operation difficulty by evaluating of the preoperative clinical data, which will help the operator to perform appropriate laparoscopic operations according to their own actual level, accordingly, to improve the success rate, reduce the rate of transit open operation and serious complications.
出处
《安徽医学》
2012年第5期560-562,共3页
Anhui Medical Journal
关键词
腹腔镜术
胆囊切除
术前评估
Laparoscopic surgery
Cystic resection
Preoperative assessment
