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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

Early vs. interval approach to laparoscopic cholecystectomy for acute cholecystitis: a retrospective observational study from Pakistan.

作者信息

Raja Sandesh, Ali Azzam, Kumar Dileep, Raja Adarsh, Samo Khursheed Ahmed, Memon Amjad Siraj

机构信息

Department of Surgery, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.

Department of Surgery, Dr. Ruth K. M. Pfau, Civil Hospital Karachi, Karachi, Pakistan.

出版信息

Front Surg. 2024 Sep 6;11:1462885. doi: 10.3389/fsurg.2024.1462885. eCollection 2024.

Abstract

BACKGROUND

Laparoscopic cholecystectomy (LC) is the preferred treatment for acute cholecystitis (AC). However, the optimal timing for LC in AC management remains uncertain, with early cholecystectomy (EC) and interval cholecystectomy (IC) being two common approaches influenced by various factors.

METHODS

This retrospective study, conducted at a tertiary care teaching hospital in Karachi, Pakistan, aimed to compare the outcomes of EC vs. IC for AC management. Patient data from January 2019 to September 2019 were analyzed with a focus on operative complications, duration of surgery, and postoperative hospital stay. The inclusion criteria were based on the Tokyo Guidelines, and patients underwent LC within 3 days of symptom onset in the EC group and after 6 weeks in the IC group.

RESULTS

Among 147 eligible patients, 100 underwent LC (50 in each group). No significant differences were observed in the sex distribution or mean age between the two groups. The EC group experienced fewer operative complications (12%) than the IC group (34%), with statistically significant differences observed. Nevertheless, no substantial variations in operative time or postoperative hospital stay were observed between the groups.

CONCLUSION

Reduced complications in the EC group underscore its safety and efficacy. Nonetheless, further validation through multicenter studies is essential to substantiate these findings.

摘要

背景

腹腔镜胆囊切除术(LC)是急性胆囊炎(AC)的首选治疗方法。然而,在AC治疗中LC的最佳时机仍不确定,早期胆囊切除术(EC)和间隔期胆囊切除术(IC)是受多种因素影响的两种常见方法。

方法

这项回顾性研究在巴基斯坦卡拉奇的一家三级护理教学医院进行,旨在比较EC与IC治疗AC的结果。分析了2019年1月至2019年9月的患者数据,重点关注手术并发症、手术持续时间和术后住院时间。纳入标准基于东京指南,EC组患者在症状出现后3天内接受LC,IC组患者在症状出现6周后接受LC。

结果

在147例符合条件的患者中,100例接受了LC(每组50例)。两组之间的性别分布或平均年龄无显著差异。EC组的手术并发症(12%)少于IC组(34%),差异有统计学意义。然而,两组之间的手术时间或术后住院时间没有实质性差异。

结论

EC组并发症减少凸显了其安全性和有效性。尽管如此,通过多中心研究进行进一步验证对于证实这些发现至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a999/11412953/01415bb2c93a/fsurg-11-1462885-g001.jpg

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