急性胆囊炎的早期腹腔镜胆囊切除术：我们应该在第一周之后进行手术吗？
Early laparoscopic cholecystectomy for acute cholecystitis: should we operate beyond the first week?
作者信息
Barka Malek, Jarrar Mohamed Salah, Sahli Jihene, Abdessalem Zied Ben, Hamila Fehmi, Youssef Sabri
机构信息
Department of General and Digestive Surgery, Farhat Hached University Hospital, Faculty of Medicine of Sousse, Sousse, Tunisia.
Department of Family and Community Medicine, Faculty of Medicine of Sousse, Sousse, Tunisia.
出版信息
Langenbecks Arch Surg. 2023 Jan 26;408(1):68. doi: 10.1007/s00423-023-02816-5.
BACKGROUND
The deadline for early laparoscopic cholecystectomy (ELC) in patients with acute calculous cholecystitis (ACC) is the subject of much debate. The aim of this study was to assess outcomes of ELC in patients with more than 7 days of symptoms.
METHODS
It is a retrospective analysis of 564 patients having undergone ELC for ACC between January 2003 and June 2021. Patients were divided into two groups according to the timing between the onset of symptoms and surgery: group 1 (G1), within the first 7 days of symptoms, and group 2 (G2) after day 7 of symptoms.
RESULTS
Apart from a longer operative time (G1 80 min vs. G2 90 min; p = 0.016), there were no significant differences regarding conversion rate (G1 14.5% vs. G2 13.2%; p = 0.748), both intra- and postoperative complications, mainly bile duct injuries (G1 0.2% vs. G2 0%; p = 1) and bile leakage (G1 1.2% vs. G2 0%; p = 1) and postoperative length of stay (G1 2 days [1-3] vs. G2 2 days [1-4]; p = 0.125).
CONCLUSION
Early laparoscopic cholecystectomy could be proposed for patients with acute calculous cholecystitis even beyond 7 days of symptoms.
背景
急性结石性胆囊炎（ACC）患者早期腹腔镜胆囊切除术（ELC）的截止时间是诸多争论的主题。本研究的目的是评估症状持续超过7天的患者接受ELC的结果。
方法
这是一项对2003年1月至2021年6月期间因ACC接受ELC的564例患者的回顾性分析。根据症状发作与手术之间的时间将患者分为两组：第1组（G1），症状出现的前7天内；第2组（G2），症状出现7天后。
结果
除了手术时间较长（G1 80分钟 vs. G2 90分钟；p = 0.016）外，在中转率（G1 14.5% vs. G2 13.2%；p = 0.748）、术中和术后并发症方面，主要是胆管损伤（G1 0.2% vs. G2 0%；p = 1）和胆漏（G1 1.2% vs. G2 0%；p = 1）以及术后住院时间（G1 2天[1 - 3] vs. G2 2天[1 - 4]；p = 0.125）方面均无显著差异。
结论
即使症状超过7天，急性结石性胆囊炎患者也可考虑行早期腹腔镜胆囊切除术。
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