METHODS: We retrospectively reviewed 100 patients with DLC after conservative AC treatment. The surgical difficulty of DLC was evaluated using a difficulty score. Based on previous studies, the highest scores in each category were categorized as grades A-C.
RESULTS: The severity of AC was mild in 51 patients and moderate in 49. Surgical outcomes revealed a distribution of difficulty scores, with grade C indicating high difficulty, showing significant differences in operative time, blood loss, achieving a critical view of safety, bailout procedures, and postoperative hospital stay compared with grades A and B. Regarding the preoperative risk factors, multivariate analysis identified age >61 years (p = .008), body mass index >27.0 kg/m2 (p = .007), and gallbladder wall thickness >6.2 mm (p = .001) as independent risk factors for grade C in DLC.
CONCLUSIONS: The difficulty score proposed in TG18 provides an objective framework for evaluating surgical difficulty, allowing for more accurate risk assessments and improved preoperative planning in DLC for AC.
方法:我们回顾性分析了100例保守AC治疗后的DLC患者。使用难度评分评估DLC的手术难度。根据以前的研究,每个类别中的最高分被归类为A-C级。
结果:51例患者AC的严重程度为轻度,49例患者为中度。手术结果显示难度分数的分布,C级表示难度高,显示手术时间的显著差异,失血,实现安全的批判性观点,救助程序,和术后住院时间与A级和B级相比,关于术前危险因素,多变量分析确定年龄>61岁(p=.008),体重指数>27.0kg/m2(p=.007),胆囊壁厚>6.2mm(p=.001)是DLCC级的独立危险因素。
结论:TG18中提出的难度评分为评估手术难度提供了客观框架,允许在DLC中进行更准确的风险评估并改进AC的术前计划。