从选择性切除胆囊切除术到突发性切除胆囊切除术:一个单一中心的经验
Evan D DeCan1, Michael E Walston1, Emily S Chang1
1Department of Surgery, Kaiser Permanante Los Angeles Medical Center, Los Angeles, CA, USA.
The American surgeon
|June 6, 2023
概括
等待60天以上的选择性胆囊切除术显著增加了紧急手术的风险. 肥胖也是预测症状胆病患者需要紧急干预的关键因素.
科学领域:
- 胃肠道学和肝胆道外科
- 手术结果研究研究.
背景情况:
- 症状性胆病 (胆结石) 经常需要选择性胆囊切除术.
- 一部分患者经历了急性胆囊炎,在选择性等待期内需要紧急手术.
- 在此期间进行紧急干预的风险因素尚未确定.
研究的目的:
- 为了确定与需要紧急胆囊切除术在预定选择性手术等待期期间相关的风险因素.
- 评估等待时间和患者人口统计学对紧急干预需求的影响.
主要方法:
- 在2017年至2022年期间计划进行选择性胆囊切除术的患者的回顾性观察性研究.
- 分析医疗记录以确定接受紧急胆囊切除术的患者.
- 选择性和紧急手术队伍之间的人口统计和等待时间的比较,包括等待时间>60天的子组分析.
主要成果:
- 在1086名患者中,48名 (4.4%) 需要紧急胆囊切除术.
- 应急组的平均等待时间 (60.3天) 与可选组 (47.3天) 相比显著更长.
- 等待期>60天 (OR 1.805) 和肥胖 (OR 未指定,P=0.0001) 是需要紧急手术的重要预测因素.
结论:
- 选择性胆囊切除术的等待时间超过60天与需要紧急手术的风险大幅增加有关.
- 肥胖是一个关键的风险因素,应考虑在分层患者紧急手术干预时.
- 这些发现有助于优化手术安排和胆病患者管理.
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