Department of Surgery, National Hospital Organization Kanazawa Medical Center, 1-1 Shimoishibiki, Kanazawa, 920-8650, Japan.
Sci Rep. 2022 Jan 11;12(1):502. doi: 10.1038/s41598-021-04479-y.
The introduction of the guidelines has resulted in an increase of laparoscopic surgeries performed, but the rate of early surgery was still low. Here, the initial effect of the introduction of the guideline was confirmed in single center, and factors disturbing early cholecystectomy were analyzed. This study included 141 patients who were treated for acute cholecystitis from January 2010 to October 2014 at Kanazawa Medical Center. Each patient was assigned into a group according to when they received treatment. Patients in Group A were treated before the Tokyo Guidelines were introduced (n = 48 cases), those in Group B were treated after the introduction of the guidelines (93 cases). After the introduction of the guidelines, early laparoscopic cholecystectomy was significantly increased (P < 0.001), however, the rate of early operations was still 38.7% only. There are many cases with cardiovascular disease in delayed group, the prevalence had reached 50% as compared with early group of 24% (P < 0.01). Approximately 25% of patients continued antiplatelet or anticoagulant therapy. In the early days of guidelines introduction, the factor which most disturbed early surgery was the coexistence of cardiovascular disease. These contents could be described in the next revision of the guidelines.
指南的引入导致腹腔镜手术的数量增加，但早期手术的比例仍然较低。在这里，我们在单中心确认了指南引入的初步效果，并分析了干扰早期胆囊切除术的因素。本研究纳入了 2010 年 1 月至 2014 年 10 月在金泽医疗中心因急性胆囊炎接受治疗的 141 例患者。根据患者接受治疗的时间，将每位患者分为一组。A 组患者在东京指南引入前接受治疗（n=48 例），B 组患者在指南引入后接受治疗（93 例）。指南引入后，早期腹腔镜胆囊切除术显著增加（P<0.001），但早期手术的比例仍仅为 38.7%。延迟组中有许多心血管疾病患者，其患病率达到 50%，而早期组为 24%（P<0.01）。约 25%的患者继续接受抗血小板或抗凝治疗。在指南引入的早期，最干扰早期手术的因素是心血管疾病的共存。这些内容可以在下一次指南修订中描述。
