Early scheduled laparoscopic cholecystectomy following percutaneous transhepatic gallbladder drainage for patients with acute cholecystitis |
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Authors: | Chikamori F Kuniyoshi N Shibuya S Takase Y |
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Institution: | (1) Department of Surgery, Kuniyoshi Hospital, Kochi, Japan, JP;(2) Department of Internal Medicine, Kuniyoshi Hospital, Kochi, Japan, JP;(3) Department of Surgery, Tsukuba Soai Hospital, Ibaraki, Japan, JP |
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Abstract: | Aim: The present study was conducted to evaluate the effectiveness of early scheduled laparoscopic cholecystectomy (LC) following
percutaneous transhepatic gallbladder drainage (PTGBD) for patients with acute cholecystitis. Patients and methods: 31 patients
with acute cholecystitis were treated by early scheduled LC following PTGBD (group 1). These patients were compared with 9
patients treated by early LC without PTGBD (group 2) and with 12 patients treated by delayed LC following conservative therapy
(group 3) for the success rate of intraoperative cholangiography, the conversion rate to open cholecystectomy, operative time,
and hospital stay. Early scheduled LC following PTGBD was defined as scheduled LC when the patient's condition recovered and
it was performed 1–7 days (mean: 4 days) after admission. The patients' age in group 1, 2, and 3 was 66 ± 13, 65 ± 10, and
64 ± 9 years, respectively, without significant difference. Most of the patients had additional diseases. Results: The success
rate of intraoperative cholangiography was 97% (30/31) in group 1, 67% (6/9) in group 2, and 67% (8/12) in group 3. The conversion
rate to open cholecystectomy was 3% (1/31) in group 1, 33% (3/9) in group 2, and 33% (4/12) in group 3. The operative time
for LC was 89 ± 33 min in group 1, 116 ± 24 min in group 2, and 135 ± 30 min in group 3. The mean hospital stay after LC was
9 ± 4 days in group 1, 9 ± 3 days in group 2, and 17 ± 7 days in group 3. In group 1, the success rate of intraoperative cholangiography
was higher, the conversion rate to open cholecystectomy was lower, and operative time was shorter than in groups 2 and 3 with
significant difference (p <0.05, p <0.05, and p <0.01, respectively). Conclusion: The findings of this study indicate that
early scheduled LC following PTGBD is a safe and effective therapeutic option for patients with acute cholecystitis especially
in elderly and complicated patients. |
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