Alsayid Muhammad, Awadalla Mohanad, Albo Betty, Talat Arslan, Wassef Wahid
Division of Gastroenterology, University of Massachusetts Memorial Medical Center, Worcester, MA, USA.
Division of Digestive Diseases, Rush University Medical Center, Chicago, IL, USA.
Dig Dis Sci. 2021 Mar;66(3):861-865. doi: 10.1007/s10620-020-06240-3. Epub 2020 Apr 4.
Laparoscopic cholecystectomy (LC) following acute gallstone cholangitis reduces the recurrence of biliary symptoms; however, the timing of LC has not been determined yet. The aim of our study was to evaluate the impact of performing LC during admission on the 30-day readmission rate.
We conducted a retrospective cohort study of acute gallstone cholangitis patients who underwent endoscopic clearance (EC) of the bile duct through endoscopic retrograde cholangiopancreatography between April 2013 and May 2018. Patients were classified into two groups: EC only group and EC followed by LC during admission (EC + LC) group. The primary outcome was the 30-day readmission rate.
A total of 95 patients with acute cholangitis were included in the analysis. Of these patients, 35 patients (36.8%) underwent LC during admission. The 30-day readmission rate was significantly lower in the EC + LC group compared to the EC group (2.9% vs. 26.7%, P 0.003). In a multivariate regression analysis, patients who underwent LC during admission had 90% lower odds of readmission within 30 days compared to patients who did not (OR 0.1, 95% CI (0.01-0.9), P 0.04).
Performing laparoscopic cholecystectomy during admission for acute gallstone cholangitis patients following endoscopic clearance of the bile duct significantly reduced the 30-day readmission rate without affecting the length of stay.
急性胆石性胆管炎后行腹腔镜胆囊切除术（LC）可降低胆道症状的复发率；然而，LC的时机尚未确定。我们研究的目的是评估住院期间行LC对30天再入院率的影响。
我们对2013年4月至2018年5月间通过内镜逆行胰胆管造影术进行胆管内镜清除（EC）的急性胆石性胆管炎患者进行了一项回顾性队列研究。患者分为两组：单纯EC组和住院期间EC后行LC（EC+LC）组。主要结局是30天再入院率。
共有95例急性胆管炎患者纳入分析。其中，35例患者（36.8%）在住院期间行LC。与EC组相比，EC+LC组的30天再入院率显著更低（2.9%对26.7%，P<0.003）。在多因素回归分析中，与未在住院期间行LC的患者相比，住院期间行LC的患者30天内再入院的几率低90%（OR 0.1，95%CI（0.01-0.9），P<0.04）。
对于急性胆石性胆管炎患者，在胆管内镜清除术后住院期间行腹腔镜胆囊切除术可显著降低30天再入院率，且不影响住院时间。
