Popkharitov Angel Iliev
Department of Surgery, Neurosurgery and Urology, Medical Faculty, Thracian University, Stara Zagora, Bulgaria.
Langenbecks Arch Surg. 2008 Nov;393(6):935-41. doi: 10.1007/s00423-008-0313-7. Epub 2008 Feb 26.
The aim of this study is to present our experience and results with performing laparoscopic cholecystectomy for acute cholecystitis evaluating the effect of timing of surgery and the influence of the various types of gallbladder inflammation on patient outcome.
The patients were separated in three groups according to the time between the onset of symptoms and the operation: the "early" group was defined as laparoscopic cholecystectomy completed in the first 72 h after the onset of the symptoms, the "intermediate" group from 4 to 7 days, and the "delayed" group with symptoms lasting more than 8 days.
Two hundred twenty-five patients underwent laparoscopic cholecystectomy. There were 115 patients who underwent "early" surgery; 70 patients underwent "intermediate" surgery, and 70 patients underwent "delay" surgery. The total number of converted cases was 32 (12.5%). There were 124 cases of acute cholecystitis, 53 cases of gangrenous cholecystitis, 27 cases of hydrops, and 51 cases of empyema. There was no significant difference in complication rate, mortality, and postoperative hospital stay.
Laparoscopic cholecystectomy can be accomplished safely in most patients with acute cholecystitis. The timing of surgery has no clinical relevant effect on conversion rates, operative times, morbidity, and postoperative hospital stay.
本研究的目的是介绍我们进行腹腔镜胆囊切除术治疗急性胆囊炎的经验和结果，评估手术时机的影响以及各种类型胆囊炎症对患者预后的影响。
根据症状出现至手术的时间将患者分为三组：“早期”组定义为症状出现后72小时内完成腹腔镜胆囊切除术，“中期”组为4至7天，“延迟”组为症状持续超过8天。
225例患者接受了腹腔镜胆囊切除术。115例患者接受了“早期”手术；70例患者接受了“中期”手术，70例患者接受了“延迟”手术。中转病例总数为32例（12.5%）。急性胆囊炎124例，坏疽性胆囊炎53例，胆囊积水27例，积脓51例。并发症发生率、死亡率和术后住院时间无显著差异。
大多数急性胆囊炎患者可安全地完成腹腔镜胆囊切除术。手术时机对中转率、手术时间、发病率和术后住院时间无临床相关影响。
