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目的探讨急性结石性胆囊炎行LC(Laparoscopic Cholecystectomy,LC)手术难易程度的相关因素。方法将245例急性结石性胆囊炎患者根据手术时间和有无中转分成容易组(123例)和困难组(122例)(含中转开腹组33例open cholecystectomy,OC),分别比较各组术前一般资料、术前影像学差异和腹腔镜下所见,筛选出有统计学差异的指标。结果术前资料中,容易组和困难组在体温、白细胞计数,手术时机、胆囊壁厚度、胆囊体积、胆总管直径各指标间差异有统计学意义(均P<0.05);术中镜下所见,两组在胆囊壁厚度、大小、颈部结石嵌顿、胆总管直径、胆囊三角各指标间差异均有统计学意义(均P<0.01)。结论急性结石性胆囊炎体温升高,白细胞计数增加,胆囊壁增厚、胆囊体积增大、胆总管直径大于8mm、颈部结石嵌顿、Calot三角不清是行LC困难的因素。
Objective To investigate the related factors of the difficulty of LC surgery in acute calculous cholecystitis. Methods A total of 245 patients with acute calcific cholecystitis were divided into two groups: the easy group (123 cases) and the difficult group (122 cases), including 33 cases of open cholecystectomy (OC) Before the general information, preoperative imaging differences and laparoscopic see, screening out statistically significant indicators. Results In the preoperative data, there were significant differences in the indexes of body temperature, white blood cell count, operation time, gallbladder wall thickness, gallbladder volume and common bile duct diameter between the easy group and the difficult group (all P <0.05) See, the two groups in the gallbladder wall thickness, size, neck incarceration, common bile duct diameter, gallbladder trigonometry various indicators were statistically significant (all P <0.01). Conclusions Acute calcific cholecystitis is associated with elevated temperature, increased white blood cell count, thickening of the gallbladder wall, enlargement of the gallbladder volume, enlargement of the common bile duct diameter of more than 8 mm, incarceration of the cervical stone, and unclear Calot triggers.