Impact of Delayed Laparoscopic Cholecystectomy After Percutaneous Transhepatic Gallbladder Drainage for Patients With Complicated Acute Cholecystitis
Impact of Delayed Laparoscopic Cholecystectomy After Percutaneous Transhepatic Gallbladder Drainage for Patients With Complicated Acute Cholecystitis
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DOI：
10.1097/sle.0b013e318188e2fe
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发表时间：
2009-02-01
影响因子：
1
通讯作者：
Shin, Jun Ho
中科院分区：
文献类型：
--
作者：
Kim, Hyung Ook;Son, Byung Ho;Shin, Jun Ho
腹腔镜胆囊切除术（LC）治疗复杂的急性胆囊炎的并发症和转换为开放胆囊切除术的高发生率相关。经皮经肝胆囊引流术（PTGBD）是一种安全有效的治疗急性胆囊炎症的方法。本研究回顾性分析了2002年1月至2007年1月间我院合并或不合并PTGBD的合并急性胆囊炎行LC的患者。患者分为3组：1组，术前未出现PTGBD的LC患者（n = 60）；组2。在PTGBD发生后7天内接受早期LC的患者（n = 35）；第三组为PTGBD后LC平均延迟19.9天（范围14 - 39天）的患者（n = 38）。3组转开腹胆囊切除术率及术后并发症发生率低于1组（P < 0.05）。PTGBD后选择性延迟LC可降低合并急性胆囊炎患者的转化率和并发症发生率。
Laparoscopic cholecystectomy (LC) for complicated acute cholecystitis is associated with high rates of complications and conversion to open cholecystectomy. Percutaneous transhepatic gallbladder drainage (PTGBD) is a safe and effective treatment for acute inflammation of the gallbladder. This study was a retrospective analysis of patients who underwent an LC with or without PTGBD for complicated acute cholecystitis at our hospital between January 2002 and January 2007. Patients were classified into 3 groups: group 1, patients who underwent an LC without preoperative PTGBD (n = 60); group 2. patients who underwent an early scheduled LC within 7 days of PTGBD (n = 35); and group 3, patients in whom the LC was delayed for a mean of 19.9 days (range, 14 to 39 d) after PTGBD (n = 38). The conversion rate to open cholecystectomy and the postoperative complication rate were lower in group 3 than in group 1 (P < 0.05). Elective delayed LC after PTGBD may lower the conversion and complication rates of patients with complicated acute cholecystitis.