Evaluation And Prediction Of The Difficulty Of Laparoscopic Cholecystectomy

Objective:Through the correlation analysis of preoperative,intraope-rative and general conditions of patients,the degree of difficulty of surgery was evaluated and predicted,so as to implement laparoscopic cholecyst-ectomy safely and effectively and reduce postoperative complications.Methods:The age,body mass index(BMI),preoperative time,white blood cell count,proportion of neutrophils,operative time,intraoperative blood loss and other clinical data of 130 patients undergoing LC treatment for acute cholecyst-itis in our department were retrospectively studied.In this paper,SPSS 22.0statistical software was used for statistical analysis of the research results.Scatter plot and fitting parabola were made between independent variables and dependent variables,critical points of each variable were calculated,and correlation analysis was performed.Rank sum test,variance analysis,linear regression and correlation analysis were used for comparison between groups.Operation time and blood loss were dependent variables,and the remaining variables were independent variables.Counting data were represented by n(%),non-normal distribution data by median,.The R value indicates the degree of correlation.P<0.05 was considered statistically significant.Results:there was a statistical difference(P<0.05)and a high correlation between different age groups in operation time.R~2 was 0.1099,which was greater than the R~2 value calculated by other factors.There was a statistically significant difference in operative time between groups with different neutrophil percentage factors(P<0.05),and the correlation was lower than that of age(R~2=0.0961<0.1099).There was no significant difference in operative time between different group of BMI(P>0.05),and the correlation was very low.There was no correlation between WBC count and operation time.There was no significant difference in operative time between groups of different preoperative time factors(P>0.05),and the correlation coefficient was close to0,with no significant correlation.there was no statistical difference in blood loss among different age groups,neutrophil percentage and BMI(P>0.05),and the correlation was very low.There was no correlation between WBC count and blood loss.There was no statistically significant difference in the amount of bleeding between groups at different preoperative times(P>0.05),and the correlation coefficient was close to 0,with no significant correlation.Conclusions:1.There is a high correlation between age and operation time,which is of great predictive significance.With the increase of age,especially over 55years old,the operation time was significantly prolonged.2.The statistical results showed that there was no significant correlation between white blood cell count,operation time and blood loss.The percentage of neutrophils was significantly correlated with the operation t ime,indicating that the degree of inflammation affected the operation difficulty.3.BMI range:18.10Kg/m~2-35.26 Kg/m~2.The final results showed that BMI had no significant influence on the operation time and difficulty within this range.4.The results showed that there was no correlation between the pre operative time and the operative time,that is,the operative time had no significant influence in the range of 24h-534h,and LC treatment could be conducted safely and effectively.After the onset of acute cholecystitis,there was no significant difference in the difficulty of LC among senior hepatobiliary surgeons at least 193.55h(8d).