Department of Surgery, Cosmos Hospital, Usuki, Japan.
Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Yufu, Japan.
Asian J Endosc Surg. 2020 Jul;13(3):351-358. doi: 10.1111/ases.12743. Epub 2019 Aug 7.
The aim of this study was to clarify the impact of dementia on surgical outcomes of laparoscopic cholecystectomy for symptomatic cholelithiasis and acute cholecystitis.
We reviewed medical data of 96 patients who underwent laparoscopic cholecystectomy for symptomatic cholecystitis and acute cholecystitis. The patients were divided into the dementia group (n = 18) and non-dementia group (n = 78). Clinical features of the patients and surgical outcomes were compared between the two groups.
Mean age and rates of The American Society of Anesthesiologists Physical Status classification score > 2 in the dementia group were significantly higher than those of the non-dementia group (P < .001, P = .008, respectively). Incidences of acute cholecystitis and the rate of percutaneous transhepatic gallbladder drainage in the dementia group were significantly higher than those of the non-dementia group (P = .009, P = .01, respectively). The rates of conversion to laparotomy and non-surgical complications in the dementia group were higher than those in the non-dementia group (P = .02, P = .03, respectively). Postoperative hospital stay in the dementia group was significantly longer than that in the non-dementia group (15.2 ± 9.3 vs 8.2 ± 3.2 days, P = .009). Subgroup analysis of patients with acute cholecystitis showed postoperative hospital stay in the dementia group to be significantly longer than that in the non-dementia group (18.7 ± 10.7 vs 10.3 ± 4.2 days, P = .03).
Patients with dementia who underwent laparoscopic cholecystectomy have a high incidence of acute cholecystitis and a high rate of percutaneous transhepatic gallbladder drainage, which may result in increased rates of conversion to laparotomy and prolong the postoperative hospital stay.
本研究旨在阐明痴呆症对有症状的胆囊结石和急性胆囊炎行腹腔镜胆囊切除术的手术结果的影响。
我们回顾了 96 例行腹腔镜胆囊切除术治疗有症状的胆囊炎和急性胆囊炎患者的医疗数据。将患者分为痴呆组（n = 18）和非痴呆组（n = 78）。比较两组患者的临床特征和手术结果。
痴呆组的平均年龄和美国麻醉医师协会身体状况分类评分>2 的发生率明显高于非痴呆组（P <.001，P =.008）。痴呆组急性胆囊炎的发生率和经皮经肝胆囊引流率明显高于非痴呆组（P =.009，P =.01）。痴呆组中转开腹率和非手术并发症发生率高于非痴呆组（P =.02，P =.03）。痴呆组的术后住院时间明显长于非痴呆组（15.2±9.3 vs 8.2±3.2 天，P =.009）。急性胆囊炎患者的亚组分析显示，痴呆组的术后住院时间明显长于非痴呆组（18.7±10.7 vs 10.3±4.2 天，P =.03）。
行腹腔镜胆囊切除术的痴呆症患者急性胆囊炎发生率高，经皮经肝胆囊引流率高，可能导致中转开腹率增加，术后住院时间延长。
