Takemoto Yu-Ki, Abe Tomoyuki, Amano Hironobu, Hanada Keiji, Fujikuni Nobuaki, Yoshida Makoto, Kobayashi Tsuyoshi, Ohdan Hideki, Noriyuki Toshio, Nakahara Masahiro
Department of Surgery, Onomichi General Hospital, Hirahara, Onomichi City, Hiroshima, Japan.
Department of Surgery, Onomichi General Hospital, Hirahara, Onomichi City, Hiroshima, Japan.
Am J Surg. 2017 Aug;214(2):262-266. doi: 10.1016/j.amjsurg.2017.01.015. Epub 2017 Jan 10.
Urgent cholecystectomy within 72 h from symptom onset is recommended. We assessed the feasibility of performing late cholecystectomy (4-7 days from symptom onset) for acute cholecystitis.
One hundred sixty-four patients with grades 1 and 2 cholecystitis, who underwent urgent cholecystectomy within 7 days from symptom onset between June 2011 and June 2015 were enrolled. One hundred thirteen patients underwent operation within 72 h from symptom onset (early operation group), and 51 underwent operation between 4 and 7 days (late operation group). Surgical outcomes and postoperative complications were analyzed using propensity score-matching analysis.
The rate of conversion, intraoperative bleeding, and complications were comparable between the groups. After a one-to-two propensity score-matched analysis was performed, outcomes of the late operation group were not inferior to those of the early operation group.
Late cholecystectomy was acceptable for treating grades 1 and 2 acute cholecystitis.
建议在症状出现后72小时内进行急诊胆囊切除术。我们评估了对急性胆囊炎行延迟胆囊切除术（症状出现后4 - 7天）的可行性。
纳入2011年6月至2015年6月期间164例1级和2级胆囊炎患者，这些患者在症状出现后7天内接受了急诊胆囊切除术。113例患者在症状出现后72小时内接受手术（早期手术组），51例在4至7天之间接受手术（延迟手术组）。采用倾向评分匹配分析对手术结果和术后并发症进行分析。
两组之间的中转率、术中出血量和并发症发生率相当。在进行一对一至二的倾向评分匹配分析后，延迟手术组的结果不低于早期手术组。
延迟胆囊切除术对于治疗1级和2级急性胆囊炎是可接受的。
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