Chong Jae Uk, Lee Jin Ho, Yoon Young Chul, Kwon Kuk Hwan, Cho Jai Young, Kim Say-Jun, Kim Jae Keun, Kim Sung Hoon, Choi Sae Byeol, Kim Kyung Sik
Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Department of Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
Korean J Hepatobiliary Pancreat Surg. 2016 Feb;20(1):12-6. doi: 10.14701/kjhbps.2016.20.1.12. Epub 2016 Feb 19.
BACKGROUNDS/AIMS: Laparoscopic cholecystectomy can reduce postoperative pain and recovery time. However, some patients experience prolonged postoperative hospital stay. We aimed to identify factors influencing the postoperative hospital stay after laparoscopic cholecystectomy.
Patients (n=336) undergoing laparoscopic cholecystectomy for gallbladder pathology at 8 hospitals were enrolled and divided into 2 groups: 2 or less and more than 2 days postoperative stay. Perioperative factors and patient factors were retrospectively analyzed.
The patient population median age was 52 years, and consisted of 32 emergency and 304 elective operations. A univariate analysis of perioperative factors revealed significant differences in operation time (p<0.001), perioperative transfusion (p=0.006), emergency operation (p<0.001), acute inflammation (p<0.001), and surgical site infection (p=0.041). A univariate analysis of patient factors revealed significant differences in age (p<0.001), gender (p=0.036), diabetes mellitus (p=0.011), preoperative albumin level (p=0.024), smoking (p=0.010), and American Society of Anesthesiologists score (p=0.003). In a multivariate analysis, operation time (p<0.001), emergency operation (p<0.001), age (p=0.014), and smoking (p=0.022) were identified as independent factors influencing length of postoperative hospital stay.
Operation time, emergency operation, patient age, and smoking influenced the postoperative hospital stay and should be the focus of efforts to reduce hospital stay after laparoscopic cholecystectomy.
背景/目的：腹腔镜胆囊切除术可减轻术后疼痛并缩短恢复时间。然而，一些患者术后住院时间延长。我们旨在确定影响腹腔镜胆囊切除术后住院时间的因素。
选取8家医院因胆囊病变接受腹腔镜胆囊切除术的患者（n = 336），分为两组：术后住院2天及以下和超过2天。对围手术期因素和患者因素进行回顾性分析。
患者人群中位年龄为52岁，包括32例急诊手术和304例择期手术。围手术期因素的单因素分析显示，手术时间（p < 0.001）、围手术期输血（p = 0.006）、急诊手术（p < 0.001）、急性炎症（p < 0.001）和手术部位感染（p = 0.041）存在显著差异。患者因素的单因素分析显示，年龄（p < 0.001）、性别（p = 0.036）、糖尿病（p = 0.011）、术前白蛋白水平（p = 0.024）、吸烟（p = 0.010）和美国麻醉医师协会评分（p = 0.003）存在显著差异。多因素分析确定手术时间（p < 0.001）、急诊手术（p < 0.001）、年龄（p = 0.014）和吸烟（p = 0.022）为影响术后住院时间的独立因素。
手术时间、急诊手术、患者年龄和吸烟影响术后住院时间，应作为缩短腹腔镜胆囊切除术后住院时间的努力重点。
