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Preoperative Waiting Time Affects the Length of Stay of Patients Treated via Laparoscopic Cholecystectomy in an Acute Care Surgical Setting.在急性护理手术环境中,术前等待时间会影响接受腹腔镜胆囊切除术患者的住院时间。
J Clin Med. 2024 Nov 29;13(23):7263. doi: 10.3390/jcm13237263.
2
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Early versus delayed laparoscopic cholecystectomy for acute cholecystitis: an up-to-date meta-analysis of randomized controlled trials.早期与延迟腹腔镜胆囊切除术治疗急性胆囊炎的比较:一项最新的随机对照试验荟萃分析。
Surg Endosc. 2018 Dec;32(12):4728-4741. doi: 10.1007/s00464-018-6400-0. Epub 2018 Aug 23.

本文引用的文献

1
Timing of CHolecystectomy In Severe PAncreatitis (CHISPA): study protocol for a randomized controlled trial.重症胰腺炎胆囊切除术时机(CHISPA):一项随机对照试验的研究方案
BMJ Surg Interv Health Technol. 2024 Mar 7;6(1):e000246. doi: 10.1136/bmjsit-2023-000246. eCollection 2024.
2
Impact of preoperative factors and waiting time on post-appendectomy complications: a retrospective study.术前因素及等待时间对阑尾切除术后并发症的影响:一项回顾性研究。
Perioper Med (Lond). 2024 Feb 21;13(1):8. doi: 10.1186/s13741-024-00365-z.
3
Acute cholecystitis management in high-risk, critically ill, and unfit-for-surgery patients: the Italian Society of Emergency Surgery and Trauma (SICUT) guidelines.高危、重症和不适宜手术的急性胆囊炎患者的治疗:意大利急诊外科和创伤学会(SICUT)指南。
Updates Surg. 2024 Apr;76(2):331-343. doi: 10.1007/s13304-023-01729-8. Epub 2023 Dec 28.
4
Comparative Safety of Robotic-Assisted vs Laparoscopic Cholecystectomy.机器人辅助与腹腔镜胆囊切除术的比较安全性。
JAMA Surg. 2023 Dec 1;158(12):1303-1310. doi: 10.1001/jamasurg.2023.4389.
5
Early laparoscopic cholecystectomy for acute cholecystitis following the Tokyo Guidelines 2018: a prospective single-center study of 201 consecutive cases.2018 年东京指南指导下急性胆囊炎早期腹腔镜胆囊切除术:一项前瞻性单中心连续 201 例病例研究。
Surg Endosc. 2023 Aug;37(8):6051-6061. doi: 10.1007/s00464-023-10094-x. Epub 2023 Apr 28.
6
Timing of Elective Cholecystectomy After Acute Cholecystitis: A Population-based Register Study.急性胆囊炎后择期行胆囊切除术的时机:一项基于人群的登记研究。
World J Surg. 2023 Jan;47(1):152-161. doi: 10.1007/s00268-022-06772-x. Epub 2022 Oct 24.
7
Acute cholecystitis: Delayed cholecystectomy has lesser perioperative morbidity compared to emergency cholecystectomy.急性胆囊炎:与急诊胆囊切除术相比,延期胆囊切除术的围手术期并发症较少。
Surgery. 2022 Jul;172(1):16-22. doi: 10.1016/j.surg.2022.03.024. Epub 2022 Apr 20.
8
Prediction of difficult laparoscopic cholecystectomy: An observational study.困难腹腔镜胆囊切除术的预测:一项观察性研究。
Ann Med Surg (Lond). 2021 Nov 14;72:103060. doi: 10.1016/j.amsu.2021.103060. eCollection 2021 Dec.
9
The Relationship between Pre-Admission Waiting Time and the Surgical Outcomes after Hip Fracture Operation in the Elderly.老年人髋部骨折手术入院前等待时间与手术结局的关系
J Nutr Health Aging. 2021;25(8):951-955. doi: 10.1007/s12603-021-1656-9.
10
Impact of Early Cholecystectomy on the Cost of Treating Mild Gallstone Pancreatitis: Gallstone PANC Trial.早期胆囊切除术对轻度胆石性胰腺炎治疗费用的影响:胆石性胰腺炎试验
J Am Coll Surg. 2021 Oct;233(4):517-525.e1. doi: 10.1016/j.jamcollsurg.2021.06.023. Epub 2021 Jul 26.

在急性护理手术环境中,术前等待时间会影响接受腹腔镜胆囊切除术患者的住院时间。

Preoperative Waiting Time Affects the Length of Stay of Patients Treated via Laparoscopic Cholecystectomy in an Acute Care Surgical Setting.

作者信息

Bressan Livia, Cimino Matteo Maria, Vaccari Federica, Capozzela Eugenia, Biloslavo Alan, Porta Matteo, Bortul Marina, Kurihara Hayato

机构信息

Department of Emergency Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milano, Italy.

Department of General Surgery, Cattinara University Hospital, Azienda Sanitaria Universitaria Giuliano Isontina (ASU GI), Trieste University, Strada di Fiume 447, 34149 Trieste, Italy.

出版信息

J Clin Med. 2024 Nov 29;13(23):7263. doi: 10.3390/jcm13237263.

DOI:10.3390/jcm13237263
PMID:39685722
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11642919/
Abstract

Acute cholecystitis (AC) presents a significant burden in emergency surgical settings. Early laparoscopic cholecystectomy (ELC) is the standard of care for AC, yet its implementation varies. This study aims to assess the impact of preoperative waiting time (WT) on postoperative length of stay (LOS) in patients undergoing urgent cholecystectomy. From June 2021 to September 2022, data on patients undergoing urgent cholecystectomy for AC or pancreatitis were collected from two university hospitals. Patients were categorized into early (ELC) or delayed (DLC) cholecystectomy groups based on WT. The primary outcome was the assessment of the variables influencing LOS via univariate and multivariate analyses. This study included 170 patients, predominantly female, with a median age of 64.50 years. ELC was performed in 58.2% of cases, with a median WT of 0 days, while DLC was performed in 41.8%, with a median WT of 3 days. Postoperative complications occurred in 21.8% of cases, with LOS being significantly shorter in the ELC group (median 5 days vs. 9 days; = 0.001). Multivariate analysis confirmed that WT (OR 8.08 (1.65-77.18; = 0.033)) was the most important predictor of LOS. ELC is associated with a shorter LOS and with DLC, aligning with the WSES recommendations. Earlier surgery reduces the risk of complications and overall hospital costs. An extended WT contributes to a prolonged LOS, underscoring the importance of timely access to operating theaters for acute biliary pathologies.

摘要

急性胆囊炎(AC)在急诊手术环境中带来了重大负担。早期腹腔镜胆囊切除术(ELC)是AC的标准治疗方法,但其实施情况各不相同。本研究旨在评估术前等待时间(WT)对接受紧急胆囊切除术患者术后住院时间(LOS)的影响。2021年6月至2022年9月,从两家大学医院收集了因AC或胰腺炎接受紧急胆囊切除术患者的数据。根据WT将患者分为早期(ELC)或延迟(DLC)胆囊切除术组。主要结果是通过单因素和多因素分析评估影响LOS的变量。本研究纳入了170例患者,以女性为主,中位年龄为64.50岁。58.2%的病例进行了ELC,中位WT为0天,而41.8%的病例进行了DLC,中位WT为3天。21.8%的病例发生了术后并发症,ELC组的LOS明显更短(中位5天对9天;P = 0.001)。多因素分析证实,WT(OR 8.08(1.65 - 77.18;P = 0.033))是LOS的最重要预测因素。ELC与较短的LOS相关,与DLC相比,符合WSES的建议。早期手术可降低并发症风险和总体医院成本。延长的WT会导致LOS延长,强调了及时进入手术室治疗急性胆道疾病的重要性。