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首页> 外文期刊>Surgical Endoscopy >A diagnostic score to predict the difficulty of a laparoscopic cholecystectomy from preoperative variables.
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A diagnostic score to predict the difficulty of a laparoscopic cholecystectomy from preoperative variables.

机译：从术前变量预测腹腔镜胆囊切除术难度的诊断评分。

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BACKGROUND: Modified logistic regression analysis of 24 variables in 300 patients undergoing laparoscopic cholecystectomy found the following parameters independently predictive for a difficult operation: right upper quadrant pain (p < 0.01), rigidity in right upper abdomen (p < 0.01), previous upper abdominal surgery (p < 0.01), biliary colic within the last 3 weeks (p < 0.05), white blood cell count > 10 x 10(9)/l (p < 0.05), thickening of the gallbladder wall (p < 0.05), hydroptic gallbladder (p < 0.05), pericholecystic fluid (p < 0.01), shrunken gallbladder (p < 0.01), and no filling of the gallbladder in preoperative intravenous cholangiography (p < 0.05). METHODS: Based on these variables a diagnostic model was developed to predict the difficulty of a laparoscopic cholecystectomy, with scores ranging from 0 (ideal case) to IV (conversion to open cholecystectomy expected) prior to surgery. RESULTS: When the reliability of our model was examined in a second study in 340 consecutive patients undergoing laparoscopic cholecystectomy 80% of the patients were predicted correctly. CONCLUSIONS: Our model should help to select patients for either laparoscopic or open cholecystectomy based on the expected difficulties and the experience of the surgeon.
机译：背景：对300例接受腹腔镜胆囊切除术的患者进行24变量的修正logistic回归分析，发现以下参数可独立预测手术困难：右上腹疼痛（p <0.01），右上腹僵硬（p <0.01），上腹部先前手术（p <0.01），最近3周内胆绞痛（p <0.05），白细胞计数> 10 x 10（9）/ l（p <0.05），胆囊壁增厚（p <0.05），术前静脉胆道造影中胆囊积液（p <0.05），胆囊液（p <0.01），胆囊收缩（p <0.01）和胆囊未充盈（p <0.05）。方法：基于这些变量，开发了一种诊断模型来预测腹腔镜胆囊切除术的难度，术前评分范围为0（理想情况）至IV（预期转换为开腹胆囊切除术）。结果：当我们的模型的可靠性在第二项研究中对340例接受腹腔镜胆囊切除术的连续患者进行了检查时，可以正确预测80％的患者。结论：我们的模型应根据预期的困难和外科医生的经验，帮助选择腹腔镜或开腹胆囊切除术的患者。

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