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早期与延迟腹腔镜胆囊切除术治疗急性胆囊炎:单中心经验。

Early Versus Delayed Laparoscopic Cholecystectomy for Acute Cholecystitis: A Single Center Experience.

出版信息

Chirurgia (Bucur). 2024 Feb;119(1):44-55. doi: 10.21614/chirurgia.2024.v.119.i.1.p.44.

DOI:10.21614/chirurgia.2024.v.119.i.1.p.44
PMID:38465715
Abstract

Acute cholecystitis (AC) represents a public health problem, increasing hospitalization costs, especially determined by the surgical treatment of these patients. Laparoscopic cholecystectomy (LC) has become the therapeutic gold standard, the timing of the intervention: early (ELC) versus late (DLC), is still debated, impacting the results. The primary objective of the study was to compare postoperative outcomes between ELC and DLC. Secondary objectives assessed surgical outcomes from the pre-pandemic period with those from the Covid-19 pandemic. Material and methods: A retrospective observational study is presented of 266 patients diagnosed with AC who were admitted to Clinic I of General Surgery, County Emergency Clinical Hospital of T #226;rgu Mure #351;, from 2018 to 2022. They were classified into the ELC group ( 72 hours from the onset of symptoms) and DLC ( 72 hours from symptom onset) and were further stratified into prepandemic and pandemic cohorts. Data on clinical symptoms, paraclinical data, surgical details, and postoperative course were collected and analyzed. The results confirm fewer conversions to open surgery and reduced hospitalization in the ELC group. The pandemic did not significantly alter the timing of surgeries or patient demographics. Conclusion: In conclusion, ELC for AC patients offers significant advantages, justifying its preference over DLC Despite the decrease in the incidence of AC hospitalizations during the pandemic, postoperative outcomes are comparable to those in the pre-pandemic period. Future multicenter studies are recommended for a broader analysis of the efficacy of laparoscopic surgery in emergency settings.

摘要

急性胆囊炎(AC)是一个公共卫生问题,增加了住院费用,尤其是这些患者的手术治疗费用。腹腔镜胆囊切除术(LC)已成为治疗的金标准,干预的时机:早期(ELC)与晚期(DLC)仍存在争议,影响了结果。本研究的主要目的是比较 ELC 和 DLC 术后结果。次要目标评估了大流行前和新冠疫情期间的手术结果。

材料和方法

回顾性观察研究了 2018 年至 2022 年期间在 T #226;rgu Mure #351;县急诊临床医院普外科 I 就诊的 266 例确诊为 AC 的患者。他们被分为 ELC 组(症状出现后 72 小时内)和 DLC 组(症状出现后 72 小时内),并进一步分为大流行前和大流行期间的队列。收集并分析了临床症状、临床数据、手术细节和术后过程的数据。结果证实,ELC 组中转开腹手术和住院时间缩短。大流行并没有显著改变手术时机或患者人群特征。

结论

总之,对于 AC 患者,ELC 具有显著优势, justifies 其优于 DLC。尽管大流行期间 AC 住院人数减少,但术后结果与大流行前相似。建议进行更多的多中心研究,以更广泛地分析腹腔镜手术在紧急情况下的疗效。

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引用本文的文献

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Cureus. 2024 Oct 22;16(10):e72090. doi: 10.7759/cureus.72090. eCollection 2024 Oct.
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Early vs. interval approach to laparoscopic cholecystectomy for acute cholecystitis: a retrospective observational study from Pakistan.急性胆囊炎腹腔镜胆囊切除术的早期与间隔期手术方式:一项来自巴基斯坦的回顾性观察研究
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