Acar Turan, Kamer Erdinç, Acar Nihan, Atahan Kemal, Bağ Halis, Hacıyanlı Mehmet, Akgül Özgün
General Surgery, MD, Ỉzmir Katip Çelebi University Atatürk Training and Research Hospital General Surgery Clinic, Turkey.
Pan Afr Med J. 2017 Jan 31;26:49. doi: 10.11604/pamj.2017.26.49.8359. eCollection 2017.
Laparoscopic cholecystectomy has become the gold standard in the treatment of symptomatic gallstones. The common opinion about treatment of acute cholecystitis is initially conservative treatment due to preventing complications of inflamation and following laparoscopic cholecystectomy after 6- 8 weeks. However with the increase of laparoscopic experience in recent years, early laparoscopic cholecystectomy has become more common.
We aimed to compare the outcomes of the patients to whom we applied early or late cholecystectomy after hospitalization from the emergency department with the diagnosis of AC between March 2012-2015.
We retrospectively reviewed the files of totally 66 patients in whom we performed early cholecystectomy (within the first 24 hours) (n: 33) and to whom we firstly administered conservative therapy and performed late cholecystectomy (after 6 to 8 weeks) (n: 33) after hospitalization from the emergency department with the diagnosis of acute cholecystitis. The groups were made up of patients who had similar clinical and demographic characteristics. While there were no statistically significant differences between the durations of operation, the durations of hospitalization were longer in those who underwent early cholecystectomy. Moreover, more complications were seen in the patients who underwent early cholecystectomy although the difference was not statistically significant.
Early cholecystectomy is known to significantly reduce the costs in patients with acute cholecystitis. However, switching to open surgery as well as increase of complications in patients who admitted with severe inflammation attack and who have high comorbidity, caution should be exercised when selecting patients for early operation.
腹腔镜胆囊切除术已成为治疗有症状胆结石的金标准。对于急性胆囊炎的治疗，普遍观点是最初进行保守治疗以预防炎症并发症，然后在6至8周后进行腹腔镜胆囊切除术。然而，近年来随着腹腔镜经验的增加，早期腹腔镜胆囊切除术变得更为常见。
我们旨在比较2012年3月至2015年期间因急性胆囊炎（AC）诊断从急诊科住院后接受早期或晚期胆囊切除术的患者的治疗结果。
我们回顾性分析了66例患者的病历，其中33例患者在急诊科住院诊断为急性胆囊炎后24小时内接受了早期胆囊切除术，另外33例患者首先接受了保守治疗，并在6至8周后接受了晚期胆囊切除术。两组患者具有相似的临床和人口统计学特征。虽然手术时间没有统计学上的显著差异，但早期胆囊切除术患者的住院时间更长。此外，早期胆囊切除术患者出现的并发症更多，尽管差异无统计学意义。
已知早期胆囊切除术可显著降低急性胆囊炎患者的费用。然而，对于因严重炎症发作入院且合并症较多的患者，转为开放手术以及并发症增加，在选择早期手术患者时应谨慎。
