Comparative Analysis of the EGS Grading System and the Tokyo Guidelines (2018) on the Surgical Treatment Results of LC in Patients with Acute Cholecystitis
Objective To compare and analyze the evaluation value of the Tokyo Guidelines (2018) (TG 2018) and EGS grading system in the outcome assessment of laparoscopic cholecystectomy (LC) for patients with acute cholecys-titis. Methods A total of 179 patients with acute cholecystitis admitted to our hospital from March 2020 to June 2023 were selected by retrospective analysis. All patients underwent LC during this hospitalization. Clinical data and treatment outcomes were collected and recorded. Quantitative scores were calculated on TG 2018 and EGS grading systems,and the differences in quantitative scores of patients with different treatment outcomes were compared. ROC curve was used to an-alyze the predictive value of TG 2018 and EGS grading on the outcome of surgical treatment. Results According to TG 2018 grading criteria,among 179 patients,31 cases were grade Ⅰ,112 cases were grade Ⅱ,and 36 cases were grade Ⅲ. Significant differences in Child-Pugh classification,perioperative complication rate,postoperative ICU admission rate,and postoperative hospital stay were observed among different TG 2018 grades (P<0.05). According to EGS grading criteria,97 cases were grade Ⅰ,53 cases were grade Ⅱ,and 29 cases were grades Ⅲ-Ⅴ. Significant differences in Child-Pugh grade,perioperative complication rate,postopera-tive ICU admission rate,and postoperative hospi-tal stay were observed among different EGS grades (P<0.05). The AUC for LC conversion to laparotomy was 0.598 (P<0.05) and 0.745 (P<0.05) for TG 2018 and EGS grad-ing,respectively;for perioperative complications,0.791 (P<0.05) and 0.747 (P<0.05);for postoperative ICU admission,0.785 (P<0.05) and 0.782 (P<0.05);and for postoperative hospital stay ≥7 days,0.693 (P<0.05) and 0.610 (P<0.05) . Conclusion TG 2018 and EGS grading systems both have certain predictive value for treatment outcomes in LC patients with acute cholecystitis. However,TG 2018 has a lower predictive value for conversion from laparoscopy to laparotomy but provides diagnostic criteria and guides clinical decisions. Both systems have their respective advantages and may be com-bined to improve prediction and clinical decision-making.
万方数据
维普
