延迟腹腔镜胆囊切除术的术前困难因素:2018年东京指南手术困难分数分析
Kei Naito1, Kotaro Suda1, Kimio Shinoda1
1Department of General Surgery, Kamitsuga General Hospital, Kanuma, Tochigi, Japan.
Asian journal of endoscopic surgery
|April 7, 2024
概括
对于急性胆囊炎 (AC) 的延迟腹腔镜胆囊切除术 (DLC) 可能具有挑战性. 这项研究确定了超过61岁的年龄,超过27岁的BMI和超过6.2毫米的胆囊壁厚度作为高难度DLC病例的预测因素.
科学领域:
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
- 医疗技术评估 医疗技术评估
背景情况:
- 2018年东京指南 (TG18) 建议急性胆囊炎 (AC) 的早期腹腔镜胆囊切除术 (LC).
- 由于慢性炎症,在AC保守治疗后延迟LC (DLC) 可能在技术上具有挑战性.
- 以前,缺乏评估LC难度的客观措施.
研究的目的:
- 为了利用TG18 25发现难度得分来识别和调查AC高难度DLC的预测因素.
- 建立一个客观的框架来评估DLC中的手术困难.
主要方法:
- 对100名接受ACDLC的患者进行了回顾性审查.
- 使用TG18难度评分评估手术难度,分为A-C等级.
- 多变量分析以确定高难度 (C级) DLC 的术前风险因素.
主要成果:
- 高难度 (C级) DLC 与显著延长的手术时间,增加的血液损失和更多的救助程序有关.
- C级DLC的独立手术前危险因素包括年龄>61岁,BMI>27.0公斤/平方米,胆囊壁厚度>6.2毫米.
- TG18难度得分有效地区分了手术难度和相关结果.
结论:
- TG18难度评分提供了一个客观的方法来评估AC的DLC手术难度.
- 这一分数有助于更准确地进行手术前风险评估,并为具有挑战性的DLC病例进行规划.
- 识别手术前的风险因素可以帮助预测和管理困难的DLC程序.
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