Paudel Rajesh
Department of Surgery, Universal College of Medical Sciences, Bhairahawa, Nepal.
JNMA J Nepal Med Assoc. 2018 Nov-Dec;56(214):945-948. doi: 10.31729/jnma.3655.
Although operation within "golden 72 hours" from the onset of symptoms has been suggested for acute calculus cholecystitis, such early surgery is hardly possible in clinical practice because of variable timing of presentation. The aim of this study is to compare the outcomes of patients undergoing laparoscopic cholecystectomy within 72 hours of symptom onset with patients undergoing surgery after 72 hours up to 7 days of symptom onset for acute calculus cholecystitis.
This is a descriptive cross-sectional study carried out from November 2016 to July 2018. Patients with acute calculus cholecystitis were divided in two groups according to the onset of symptoms. Main outcomes measured were conversion rate, duration of surgery, length of hospital stay and intraoperative complications.
Total 64 patients were evaluated. Among which 18 (28.1%) underwent surgery within 72 hours of onset of symptom. Around 46 (71.9%) underwent surgery after 72 hours of symptom onset. On bivariate analysis there were no significant differences in mean duration of surgery, hospital stay and conversion to open surgery between two groups.
Early laparoscopic cholecystectomy is a safe procedure when done within 7 days of symptom onset. There were no significant difference in conversion rate, operative time, hospital stay, morbidity and mortality.
虽然对于急性结石性胆囊炎，建议在症状出现后的“黄金72小时”内进行手术，但由于就诊时间的差异，在临床实践中很难做到如此早期的手术。本研究的目的是比较急性结石性胆囊炎患者在症状出现后72小时内接受腹腔镜胆囊切除术与在症状出现后72小时至7天接受手术的患者的治疗结果。
这是一项于2016年11月至2018年7月开展的描述性横断面研究。急性结石性胆囊炎患者根据症状出现时间分为两组。主要测量的结果包括中转率、手术时长、住院时间和术中并发症。
共评估了64例患者。其中18例（28.1%）在症状出现后72小时内接受了手术。约46例（71.9%）在症状出现72小时后接受了手术。在双变量分析中，两组之间的平均手术时长、住院时间和转为开腹手术的情况没有显著差异。
在症状出现后7天内进行早期腹腔镜胆囊切除术是一种安全的手术方式。在中转率、手术时间、住院时间、发病率和死亡率方面没有显著差异。
