Helios Klinikum Wuppertal, Department of Surgery II, Witten/Herdecke University, Heusner Strasse 40, 42283 Wuppertal, Germany ; Department of General, visceral and thoracic surgery, St. Remigius Hospital Opladen, An St. Remigius 26, 51379 Leverkusen, Germany.
Department of Internal Medicine, St. Elisabeth Hospital Hohenlind, 50377 Köln, Germany.
World J Emerg Surg. 2014 Dec 16;9(1):60. doi: 10.1186/1749-7922-9-60. eCollection 2014.
Early cholecystectomy within 72 hours has been shown to be superior to late or delayed cholecystectomy with regard to outcome and cost of treatment. Recently, immediate cholecystectomy within 24 hours of onset of symptom was proposed as standard procedure for the management of fit patients presenting with acute cholecystitis. We sort to find out if there are any differences in surgical outcomes between patients managed within 24 h and those managed 25-72 h following symptom begin for acute cholecystitis.
A retrospective analysis was performed. The outcomes of patients undergoing laparoscopic cholecystectomy within 24 h were compared to those of patients managed 25-72 h following symptom onset for acute cholecystitis.
35 patients managed 25-72 h following begin of symptoms were matched with 35 patients with similar baseline features, medical comorbidities and disease severity managed within 24 hours of symptom onset. There were no significant differences in the duration of surgery, postoperative complications, rate of conversion and length of hospital stay.
Immediate laparoscopic cholecystectomy for acute cholecystitis within 24 hour of symptom onset is not superior to surgery 25-72 hour after symptoms begin. Laparoscopic cholecystectomy for acute cholecystitis therefore can be safely performed anytime within the golden 72 h.
早期胆囊切除术在 72 小时内进行，在治疗结果和成本方面优于晚期或延迟胆囊切除术。最近，建议对有症状发作后 24 小时内的适合患者进行即刻胆囊切除术，作为急性胆囊炎的标准治疗方法。我们试图找出在急性胆囊炎症状发作后 24 小时内和 25-72 小时内接受治疗的患者之间手术结果是否存在差异。
进行了回顾性分析。比较了在症状发作后 24 小时内接受腹腔镜胆囊切除术的患者的结果，与在症状发作后 25-72 小时接受治疗的患者的结果。
35 例在症状开始后 25-72 小时接受治疗的患者与 35 例具有相似基线特征、合并症和疾病严重程度的患者进行了匹配，这些患者在症状发作后 24 小时内接受了手术。手术时间、术后并发症、转换率和住院时间无显著差异。
急性胆囊炎在症状发作后 24 小时内进行即刻腹腔镜胆囊切除术并不优于症状开始后 25-72 小时进行手术。因此，急性胆囊炎的腹腔镜胆囊切除术可以在黄金 72 小时内的任何时间安全进行。
