腹腔镜胆囊切除中转开腹手术的危险因素分析

目的：分析腹腔镜胆囊切除术中转开腹手术的危险因素。方法：回顾分析我院5年间2 850例LC临床资料，采用单因素分析至Logistic多元回归分析推算出LC中转开腹的危险因素。结果：LC中转开腹手术115例，中转率为4.03%。LC中转开腹的危险因素有近半年胆囊炎急性发作≥2次，胆囊炎病史>2年，伴有右上腹体征（右上腹压痛、肝区叩痛、Murphy′s征阳性），胆囊壁厚度≥3 mm和胆囊积液。结论：中转开腹的危险因素有近期胆囊炎发作频数、胆囊炎病史、右上腹体征、胆囊壁厚度和胆囊积液。术前仔细询问病史和完善检查，选择适合的LC患者和提高术者手术技术是降低LC中转开腹率的有效措施。对于存在危险因素的患者应适时的选择开腹手术。

Risk factors for conversion from laparoscopic to open cholecystectomy

ObjectiveTo investigate the risk factors for conversion from laparoscopic (LC) to open cholecystectomy (OC).MethodsThe clinical data of 2 850 cases of LC were retrospectively analyzed.ResultsThe occurrence rate of conversion was 4.03%. The risk factors for LC conversion to open procedure comprised:two or more attacks of acute cholecystitis in recent 6 months;history of cholecysfifis>2 years; appeared righ quadrent abdominal signs, thickness of gallbladder wall≥3 mm;and hydrops of gallbladder. ConclusionsThe risk factors for conversion of LC to OC were attacks of acute cholecystitis, the length of disease, tenderness of upper abdomen, thickening of gallbladder wall and hydrops of gallbladder. A detailed history, clinical examination with suitable imaging test,proper selection of patients and improving the skill of operators, may decrease the occurrence of the LC conversion rate and the complication after operation.OC should be selected for the patients with the above risk factors.