手术前的全身和局部炎症是经过皮肤穿透肝胆囊排水后难以进行腹腔镜胆囊切除术的独立风险因素
Hai-Hong Wei1,2, Yu-Xiang Wang3, Bin Xu3
1Department of Cardiovascular Surgery, Shanghai Tongren Hospital, Shanghai, China.
Heliyon
|September 9, 2024
概括
预测外科手术困难在透视胆囊切除术后皮肤穿透肝胆囊排水是可能的. 炎症标志物和输液的升高预测了具有挑战性的病例,有助于手术规划.
科学领域:
- 肝胆道手术是肝胆道的手术.
- 最少的侵入性手术是最少的侵入性手术.
- 手术风险分层的分层化
背景情况:
- 经皮切经肝胆囊排水 (PTGBD) 往往是急性胆囊炎的必要.
- 腹腔镜胆囊切除术 (LC) 遵循PTGBD,但预测手术困难仍然具有挑战性.
研究的目的:
- 在经过PTGBD的患者中确定困难LC的预测因子.
- 开发一个预测模型来预测这个患者群体的手术困难.
主要方法:
- 在PTGBD (2016-2022) 后接受LC的127名患者的回顾性分析.
- 根据手术时间,血液损失和转换,将手术分为困难和不困难.
- 使用后勤回归和决策曲线分析开发和验证名ogram.
主要成果:
- 升高的C-反应蛋白 (CRP),周围囊溢出,以及接近胃/十二指肠是难以发生LC的独立危险因素.
- 纳入这些因素的名图显示出良好的校准和预测性能.
- 在127名患者中,36名患者 (28.3%) 经历了困难的LC.
结论:
- 系统性和局部炎症的术前指标是PTGBD后困难的LC的有价值的预测指标.
- 开发的诺米图可以帮助这些患者进行手术前风险评估和手术规划.
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