Imaging Acutecholecystitis Laparoscipy Difficulty Judgment Value Analysis

Objective: Acute cholecystitis is a common disease of the biliary system,as the dietand patterns of life change, gallbladder stones showa trend of increasing year by year. Ithas become one of the common diseases that affect people’s quality of life, laparoscopiccholecystectomy (LC) has also become the preferred surgical approach forcholecystectomy. LC is divided into contrarian and homeopathic two categories,determined according to the operator habits and the specific circumstances of theabdominal cavity. Compared with conventional open cholecystectomy, although LCwere safe, reliable, broad vision, less trauma, less bleeding, less pain, quicker recovery,no obvious surgical scars, and other significant advantages, but limited to the inherentshortcomings of the laparoscopic instruments. Encountered severe adhesion Calottriangle, abnormal anatomical relationship, gallbladder neck stone impaction (Mirizzisyndrome), gallbladder wall edema in cases of operating difficulties due to surgery andappear acomplication. Therefore, effective use of imaging methods can be moreaccurately show gallbladder biliary tract disease, emergency (From onset to surgery≤72h)LC determination of the degree of difficulty to provide a more reliable imagingevidence. It has significant on how to accurate choice of treatment methods, to improvethe cure rate, the maximum extent to reduce the patients pain,reduce hospitalization timeand reduce the burden of patients cost.This paper retrospective analysis theUltrasonography(US) and Computed Tomography (CT), comparative evaluation of twokinds of imaging in the emergency LC, and provide a more reliable imaging evidence forthe evaluat of the degree of difficulty of emergency LC. According to the preoperative,intraoperative data, compare the two imaging inspection performance to provide areference for clinical.Methods: It carried out the comparative analysis of single factor that theimplementation of the LC157cases hospitalized due to acute cholecystitis, preoperative US,CT graphics data, intraoperative clinical data, which come from the First AffiliatedHospital of Dalian Medical University between January1,2005and March2012,screening caused by the surgical difficulties were applied to US and CT todetermine the degree of difficulty encountered in surgery before the LC compared,viewing the match degree, and testing US and CT both imaging examinationperformance.Results: Screening of the difficulty of image factors in the emergency LC, reachingcholecystitis, the gallbladder sectional area≥50cm2, gallbladder wall thickness≥0.4cm,gallbladder contraction (≤4.5cm*1.5cm), the gallbladder neck impacted stones,gallbladder and the surrounding adhesions,gallbladder and the surrounding adhesions,bile through the sound level/bile density, common bile duct diameter≥0.8cm, and otherrisk factors that lead to surgical difficulties. US projected compliance rate of89.8%(141/157).CT predicted coincidence rate was87.2%(137/157).US combine CTcomprehensive forecast projected compliance rate of94.3%(148/157).US and CT judgeemergency LC ease in line with the rate without significant difference (P>0.05).Onemethod and US combine CT comprehensive forecast sensitivity was statisticallydifference(P<0.05).Conclusions: In this study, the final results concluded through surgery, US and CTfor ease of evaluation of acute cholecystitis before the implementation of the LC was tohave an important place.Judgment gallbladder surrounding exudation howmuch,Judgment the gallbladder triangle degree of adhesion,Judgment gallbladdertriangular anatomical structures,found minimal change disease, etc,CT is superior to BUScheck.Due to the BUS low prices, on stone high detection rate, simple operation, noradioactive, high repeatability, the inconvenience of moving patients also feasiblebedside examination, if there are special requirements but also the feasible intraoperativeUS so can be used as LC examination before the preferred method.US and CT both nosignificant difference of preoperative LC difficult to judge, and there are some limitations,but combining the two methods can often point out a complementary accurate and guidetreatment.