预测腹腔镜胆囊切除术困难的风险因素:一项观察研究

Manojit Barman, Diptangshu Das, Arunava Jana, Pathik Shit
{"title":"预测腹腔镜胆囊切除术困难的风险因素:一项观察研究","authors":"Manojit Barman, Diptangshu Das, Arunava Jana, Pathik Shit","doi":"10.36106/ijsr/9205053","DOIUrl":null,"url":null,"abstract":"Background: Laparoscopic Cholecystectomy (LC) has become the gold standard in the treatment of symptomatic gallstones and it is the most\nfrequent operation now-a-days for gallbladder stones. At times laparoscopy becomes difcult and may need conversion to open cholecystectomy.\nThe prediction of a difcult cholecystectomy has traditionally been based on certain pre-operative clinical and imaging factors. Aim: To study the\nfactors determining the preoperative predictability of difcult LC based on the patient's history, physical examination and abdominal\nultrasonography. Methods: 359 patients diagnosed cholelithiasis, admitted to general surgery department, KPC MCH, Kolkata-32, West Bengal.\nAll of them underwent elective LC, and were operated by experienced laparoscopic surgeons between July 2022 and November 2023. Study\ndesign: Observational study. Results: In our study out of 359 cases 221 are male and 138 are female, male are more predominant than females\n(61% vs 38%). Among 359 patients 76 (21%) patients were found for difcult cholecystectomy. On multivariate logistic regression revealed that\nmale gender, older age, H/O acute attacks, positive Murphy´s sign, past H/O acute cholecystitis requiring hospitalisation, recent H/O jaundice, past\nH/O co-morbidities, H/O ERCP for choledocholithiasis, H/O gall stone pancreatitis, increased gall bladder wall thickness, peri-cholecystic\noedema/ collection, brotic gall bladder, intra-operative ndings of dense adhesion at calot´s triangle were independent predictors of difcult LC.\nConclusion: Pre operative prediction of possible difculties may help a surgeon in choosing the appropriate approach suitable for a particular\npatient. Patients can pre-op be informed about possible risk of conversion to open cholecystectomy","PeriodicalId":14358,"journal":{"name":"International journal of scientific research","volume":"24 6","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"PREDICTING THE RISK FACTOR FOR DIFFICULT LAPAROSCOPIC CHOLECYSTECTOMY: AN OBSERVATIONAL STUDY\",\"authors\":\"Manojit Barman, Diptangshu Das, Arunava Jana, Pathik Shit\",\"doi\":\"10.36106/ijsr/9205053\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: Laparoscopic Cholecystectomy (LC) has become the gold standard in the treatment of symptomatic gallstones and it is the most\\nfrequent operation now-a-days for gallbladder stones. At times laparoscopy becomes difcult and may need conversion to open cholecystectomy.\\nThe prediction of a difcult cholecystectomy has traditionally been based on certain pre-operative clinical and imaging factors. Aim: To study the\\nfactors determining the preoperative predictability of difcult LC based on the patient's history, physical examination and abdominal\\nultrasonography. Methods: 359 patients diagnosed cholelithiasis, admitted to general surgery department, KPC MCH, Kolkata-32, West Bengal.\\nAll of them underwent elective LC, and were operated by experienced laparoscopic surgeons between July 2022 and November 2023. Study\\ndesign: Observational study. Results: In our study out of 359 cases 221 are male and 138 are female, male are more predominant than females\\n(61% vs 38%). Among 359 patients 76 (21%) patients were found for difcult cholecystectomy. On multivariate logistic regression revealed that\\nmale gender, older age, H/O acute attacks, positive Murphy´s sign, past H/O acute cholecystitis requiring hospitalisation, recent H/O jaundice, past\\nH/O co-morbidities, H/O ERCP for choledocholithiasis, H/O gall stone pancreatitis, increased gall bladder wall thickness, peri-cholecystic\\noedema/ collection, brotic gall bladder, intra-operative ndings of dense adhesion at calot´s triangle were independent predictors of difcult LC.\\nConclusion: Pre operative prediction of possible difculties may help a surgeon in choosing the appropriate approach suitable for a particular\\npatient. Patients can pre-op be informed about possible risk of conversion to open cholecystectomy\",\"PeriodicalId\":14358,\"journal\":{\"name\":\"International journal of scientific research\",\"volume\":\"24 6\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International journal of scientific research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.36106/ijsr/9205053\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International journal of scientific research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.36106/ijsr/9205053","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

背景:腹腔镜胆囊切除术(LC)已成为治疗无症状胆结石的金标准,也是目前最常见的胆囊结石手术。有时腹腔镜手术会变得困难,可能需要转为开腹胆囊切除术。传统上,对困难胆囊切除术的预测是基于术前的某些临床和影像学因素。目的:根据患者的病史、体格检查和腹部超声检查,研究决定术前预测胆囊切除术难cult的因素。方法:西孟加拉邦加尔各答32区KPC MCH普外科收治的359名确诊为胆石症的患者。所有患者均接受了择期LC手术,并在2022年7月至2023年11月期间由经验丰富的腹腔镜外科医生进行了手术。研究设计:观察性研究。研究结果在我们的研究中,359 例患者中有 221 例为男性,138 例为女性,男性多于女性(61% vs 38%)。在 359 例患者中,76 例(21%)患者接受了双cult 胆囊切除术。多变量逻辑回归显示,男性、年龄较大、H/O 急性发作、墨菲氏征阳性、既往H/O 急性胆囊炎需要住院、近期H/O 黄疸、既往H/O 并发疾病、H/O ERCP 治疗胆总管结石、H/O 胆石性胰腺炎、H/O 胆囊切除术、H/O胆结石性胰腺炎、胆囊壁厚度增加、胆囊周围水肿/积水、brotic galladder、术中ndings of dense adhesion at calot´s triangle(卡洛氏三角区致密粘连)是胆囊切除术难cult的独立预测因素。结论:术前预测可能出现的困难可帮助外科医生选择适合特定患者的适当方法。患者可在术前了解转为开腹胆囊切除术的可能风险
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
PREDICTING THE RISK FACTOR FOR DIFFICULT LAPAROSCOPIC CHOLECYSTECTOMY: AN OBSERVATIONAL STUDY
Background: Laparoscopic Cholecystectomy (LC) has become the gold standard in the treatment of symptomatic gallstones and it is the most frequent operation now-a-days for gallbladder stones. At times laparoscopy becomes difcult and may need conversion to open cholecystectomy. The prediction of a difcult cholecystectomy has traditionally been based on certain pre-operative clinical and imaging factors. Aim: To study the factors determining the preoperative predictability of difcult LC based on the patient's history, physical examination and abdominal ultrasonography. Methods: 359 patients diagnosed cholelithiasis, admitted to general surgery department, KPC MCH, Kolkata-32, West Bengal. All of them underwent elective LC, and were operated by experienced laparoscopic surgeons between July 2022 and November 2023. Study design: Observational study. Results: In our study out of 359 cases 221 are male and 138 are female, male are more predominant than females (61% vs 38%). Among 359 patients 76 (21%) patients were found for difcult cholecystectomy. On multivariate logistic regression revealed that male gender, older age, H/O acute attacks, positive Murphy´s sign, past H/O acute cholecystitis requiring hospitalisation, recent H/O jaundice, past H/O co-morbidities, H/O ERCP for choledocholithiasis, H/O gall stone pancreatitis, increased gall bladder wall thickness, peri-cholecystic oedema/ collection, brotic gall bladder, intra-operative ndings of dense adhesion at calot´s triangle were independent predictors of difcult LC. Conclusion: Pre operative prediction of possible difculties may help a surgeon in choosing the appropriate approach suitable for a particular patient. Patients can pre-op be informed about possible risk of conversion to open cholecystectomy
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
期刊最新文献
PREVALENCE OF CRYPTOSPORIDIOSIS IN IMMUNOCOMPETENT PATIENTS IN SECONDARY CARE HOSPITAL NORTH EAST REGION PARAMETERS TO PREDICT FUNCTIONAL MATURATION AND OUTCOMES OF ARTERIOVENOUS FISTULA IN END STAGE RENAL DISEASE PATIENTS: A SINGLE CENTRE STUDY DENTOALVEOLAR COMPENSATION AND CLINICAL LONGEVITY: A 30-YEAR STUDY ON IMPLANT STABILITY IN OCCLUSAL DYNAMICS. A COMPARATIVE STUDY OF NON-DESCENT VAGINAL HYSTERECTOMY AND TOTAL LAPAROSCOPIC HYSTERECTOMY FOR BENIGN INDICATIONS - A SINGLE CENTRE EXPERIENCE ROLE OF CT UROGRAPHY IN EVALUATION OF PATIENTS WITH OBSTRUCTIVE UROPATHY: A PROSPECTIVE STUDY OF 50 PATIENTS IN A URBAN TERTIARY CARE HOSPITAL
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1