Ke C W, Wu S D, Li Y N
Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, China.
Zhonghua Yi Xue Za Zhi. 2018 Mar 13;98(10):768-772. doi: 10.3760/cma.j.issn.0376-2491.2018.10.011.
To analysis the curative effect of emergency cholecystectomy (EC) and percutaneous transhepatic gallbladder drainage (PTGBD) followed by delayed cholecystectomy (DC) on the patients with moderate acute cholecystitis. The perioperative dataof patients in EC group (=47) and in PTGBD-DC group (=49) were compared retrospectively. Compared to PTGBD+ DC group, EC patients had a significantly more postoperative abdominal drainage time [(9.0±12.9) vs (3.4±2.1) days, =0.041], more postoperative hospital stay after cholecystectomy [(8.2±3.2) vs (5.1±1.8) days, =0.004], more intraoperative bleeding [(101±125) vs (33±37) ml, =0.003], more patients of LC conversion to open cholecystectomy (OC) (19.1% vs 4.1%, =0.021) and more patients of OC(14.9% vs 0, =0.005). Also, there were higher incidence of respiratory failure(14.8% vs 2.0%, =0.029), and admission for ICU(21.3% vs 2.0 %, =0.003). Also, patients of total OC in non-biliary surgeons group were more than that of biliary surgeons group statistically(63.2% vs 14.3 %, =0.001). PTGBD followed by DC in the treatment of moderate acute cholecystitis was better than EC, especially in patients with complicated comorbidities and in non-biliary surgeons.
分析急诊胆囊切除术（EC）和经皮经肝胆囊引流术（PTGBD）联合延期胆囊切除术（DC）治疗中度急性胆囊炎患者的疗效。回顾性比较EC组（n = 47）和PTGBD-DC组（n = 49）患者的围手术期数据。与PTGBD+DC组相比，EC组患者术后腹腔引流时间显著更长[（9.0±12.9）天 vs （3.4±2.1）天，P = 0.041]，胆囊切除术后住院时间更长[（8.2±3.2）天 vs （5.1±1.8）天，P = 0.004]，术中出血量更多[（101±125）ml vs （33±37）ml，P = 0.003]，LC转为开腹胆囊切除术（OC）的患者更多（19.1% vs 4.1%，P = 0.021），OC患者更多（14.9% vs 0，P = 0.005）。此外，呼吸衰竭发生率更高（14.8% vs 2.0%，P = 0.029），入住ICU的比例更高（21.3% vs 2.0%，P = 0.003）。而且，非胆道外科医生组的全OC患者在统计学上多于胆道外科医生组（63.2% vs 14.3%，P = 0.001）。PTGBD联合DC治疗中度急性胆囊炎优于EC，尤其是在合并复杂基础疾病的患者和非胆道外科医生治疗的患者中。
