在急性胆囊炎中难以预测的 laparoscopic 胆囊切除术的预测因素
Paul Lorin Stoica1, Dragos Serban2,3, Dan Georgian Bratu4,5
1Doctoral School, Carol Davila University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania.
Diagnostics (Basel, Switzerland)
|February 10, 2024
概括
确定难以进行腹腔镜胆囊切除术 (LC) 的术前因素至关重要. 晚年,男性性别,糖尿病,晚期呈现,发烧和炎症标志物升高预测手术困难,改善患者的结果.
科学领域:
- 胃肠道学和肝胆道外科
- 手术瘤学手术瘤学
- 医学诊断 医学诊断 医学诊断
背景情况:
- 腹腔镜胆囊切除术 (LC) 是急性胆囊炎的标准治疗方法.
- 困难的LC病例,发生在大约六分之一的患者中,由于炎症和粘附,增加了血管和胆道损伤的风险.
研究的目的:
- 确定预手术参数,预测急性胆囊炎的LC接受的患者的手术困难.
- 加强手术前评估,以优化治疗决策和患者安全.
主要方法:
- 在2019年至2023年期间,对255名急性胆囊炎患者进行了回顾性研究.
- 在正常LC和困难LC (DLC) 组之间比较患者人口统计学,临床表现,实验室值和成像发现.
- 对Tongyoo评分和多变量模型的预测能力的评估.
主要成果:
- 在DLC组的患者中,并发症发生率明显较高 (33.3%与15.3%相比).
- 与DLC相关的术前因素包括年龄较大,男性性别,糖尿病,延迟呈现,发烧和阳性墨菲征兆.
- 在DLC组中观察到总白细胞,中性粒细胞和中性粒细胞与淋巴细胞比率 (NLR) 的升高.
- yoo评分 (AUC 0.856) 和一个多变量模型 (AUC 0.802) 显示出对DLC的优异预测能力.
结论:
- 在手术前确定预测难以进行腹腔镜胆囊切除术的因素至关重要.
- 临床,实验室和评分系统可以帮助预测手术困难,允许更好的手术规划和降低风险.
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