从轻度胆囊炎到坏疽性胆囊炎，腹腔镜胆囊切除术在一天 24 小时内都是安全的。
From mild to gangrenous cholecystitis, laparoscopic cholecystectomy is safe 24 hours a day.
机构信息
University of Texas Southwestern, Department of General Surgery, USA.
University of Texas Southwestern, Department of General Surgery, USA.
出版信息
Am J Surg. 2023 Jul;226(1):83-86. doi: 10.1016/j.amjsurg.2023.01.029. Epub 2023 Jan 27.
OBJECTIVES
Laparoscopic cholecystectomy (LC) at night remains controversial. Prior studies have not controlled for disease severity. We analyzed outcomes of LC performed day vs. night while controlling for the Parkland Grading Scale for Cholecystitis (PGS).
METHODS
Analysis of the AAST multicenter evaluation of cholecystitis database was performed. Exclusion criteria included non-operative cases, open operations, and missing PGS. Cases were divided based on operation start time. PGS was used to control for disease severity. Outcomes included operative time, use of bailout techniques and complications.
RESULTS
Of 759 procedures identified, 16% were nighttime LC. No differences in demographics, comorbidities, physiologic variables and PGS were noted. Operative time (108.6 min vs 105.6), bailout techniques (8.3% vs 7.4%) and complications (9.9% vs 11.3%) were similar between groups.
CONCLUSION
Regardless of severity, laparoscopic cholecystectomy is safe 24-h a day. Operations performed at night have a similar complication profile to those performed during the day.
目的
夜间腹腔镜胆囊切除术（LC）仍存在争议。先前的研究并未控制疾病的严重程度。我们分析了在控制胆囊炎 Parkland 分级量表（PGS）的情况下，日间与夜间进行 LC 的结果。
方法
对 AAST 多中心胆囊炎数据库进行了分析。排除标准包括非手术病例、开放性手术和缺失 PGS。根据手术开始时间对病例进行分组。PGS 用于控制疾病的严重程度。结果包括手术时间、使用抢救技术和并发症。
结果
在确定的 759 例手术中，16%为夜间 LC。两组在人口统计学、合并症、生理变量和 PGS 方面无差异。手术时间（108.6 分钟 vs 105.6 分钟）、抢救技术（8.3% vs 7.4%）和并发症（9.9% vs 11.3%）相似。
结论
无论严重程度如何，腹腔镜胆囊切除术 24 小时均可安全进行。夜间进行的手术与日间进行的手术具有相似的并发症谱。
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