Ozkardeş Alper Bilal, Tokaç Mehmet, Dumlu Ersin Gürkan, Bozkurt Birkan, Ciftçi Ahmet Burak, Yetişir Fahri, Kılıç Mehmet
1 Department of General Surgery, Atatürk Training and Research Hospital, Ankara, Turkey.
Int Surg. 2014 Jan-Feb;99(1):56-61. doi: 10.9738/INTSURG-D-13-00068.1.
We aimed to compare the clinical outcome and cost of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Sixty patients with acute cholecystitis were randomized into early (within 24 hours of admission) or delayed (after 6-8 weeks of conservative treatment) laparoscopic cholecystectomy groups. There was no significant difference between study groups in terms of operation time and rates for conversion to open cholecystectomy. On the other hand, total hospital stay was longer (5.2 ± 1.40 versus 7.8 ± 1.65 days; P = 0.04) and total costs were higher (2500.97 ± 755.265 versus 3713.47 ± 517.331 Turkish Lira; P = 0.03) in the delayed laparoscopic cholecystectomy group. Intraoperative and postoperative complications were recorded in 8 patients in the early laparoscopic cholecystectomy group, whereas no complications occurred in the delayed laparoscopic cholecystectomy group (P = 0.002). Despite intraoperative and postoperative complications being associated more with early laparoscopic cholecystectomy compared with delayed intervention, early laparoscopic cholecystectomy should be preferred for treatment of acute cholecystitis because of its advantages of shorter hospital stay and lower cost.
我们旨在比较早期与延迟腹腔镜胆囊切除术治疗急性胆囊炎的临床疗效和成本。60例急性胆囊炎患者被随机分为早期（入院24小时内）或延迟（保守治疗6 - 8周后）腹腔镜胆囊切除术组。研究组之间在手术时间和转为开腹胆囊切除术的比率方面无显著差异。另一方面，延迟腹腔镜胆囊切除术组的总住院时间更长（5.2±1.40天对7.8±1.65天；P = 0.04），总成本更高（2500.97±755.265土耳其里拉对3713.47±517.331土耳其里拉；P = 0.03）。早期腹腔镜胆囊切除术组有8例患者记录了术中及术后并发症，而延迟腹腔镜胆囊切除术组未发生并发症（P = 0.002）。尽管与延迟干预相比，术中及术后并发症更多与早期腹腔镜胆囊切除术相关，但由于早期腹腔镜胆囊切除术具有住院时间短和成本低的优势，治疗急性胆囊炎时应首选早期腹腔镜胆囊切除术。
