关键词: 腹腔镜, 胆囊切除术, 术前难度预测, Laparoscopic, Cholecystectomy, Preoperative Prediction

Abstract: Objective To evaluate the significance and method of preoperative prediction of the difficulty of laparoscopic cholecystectomy . Methods The preoperative clinical data was collected from 500 cases underwent LC. According to the standard of operative difficulty or ease, the 500 cases with gall bladder diseases were divided into two groups, namely difficult group and easy group.All the preoperative and operative data were compared between the two groups. Results The accuracy rate of preoperative diagnosis with sonography for cholecystolitiasis were 98.61% .465 cases were performed with LC,; 35 cases are required to convert into open cholecystectomy. The conversion rate was 7%. The total prediction accuracy of sonography was 92.4% and the sensitivity was 96.41% ,; specificity was 78.19% . Conclusions ① The diagnosis with B--type ultrasound shows high accuracy rate for the diagnosis of the disease of gallbladder , and it has a definite value for the prediction of the difficulty of LC .② Severe adhesions presented in Calot’s triangle or gallbladder , incarceration with stone at gallbladder’s neck associated with acute cholecystitis , the repletion type of cholecystolithiasis , atrophic cholecystitis and previous surgery at the upper abdomen have an important value for the evaluation of the difficultiy of the LC.