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首页> 外文期刊>The American surgeon. >Percutaneous Transhepatic Gallbladder Drainage Combined with Laparoscopic Cholecystectomy versus Emergency Laparoscopic Cholecystectomy in Acute Complicated Cholecystitis: Comparison of Curative Efficacy
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Percutaneous Transhepatic Gallbladder Drainage Combined with Laparoscopic Cholecystectomy versus Emergency Laparoscopic Cholecystectomy in Acute Complicated Cholecystitis: Comparison of Curative Efficacy

机译：经皮胸腺胆囊引流结合腹腔镜胆囊切除术与急性复杂性胆囊炎中的急诊腹腔镜胆囊切除术：疗效比较

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Controversy exists on the suitability of laparoscopic cholecystectomy (LC) in acute cholecystitis, especially in patients with severe comorbidities. Recently, many nonsurgical departments have indicated a preference for percutaneous transhepatic gallbladder drainage (PTGBD), but surgeons consider LC as the final treatment option for cholecystitis. This analysis evaluated the curative efficacy of PTGBD in combination with LC as compared with emergency LC (e-LC). We retrospectively analyzed clinical data of 86 patients with acute complicated cholecystitis. Patients were divided into two groups as those who received e-LC and those who underwent PTGBD combined with LC (PTGBD+LC), and baseline characteristics, perioperative data, and operative parameters were compared to check for intergroup differences. Baseline characteristics were similar for the study groups. However, although the operating duration (P = 0.12) and postoperative hospital stay (P = 0.39) did not evidence significant differences, the PTGBD + LC group had significantly better outcomes than the e-LC group with regard to blood loss (P < 0.05), peritoneal drainage duration (P < 0.05), and time to postoperative resumption of oral intake (P < 0.05). Moreover, conversion to open surgery, complications during LC, and mortality rate were all higher in the e-LC group. PTGBD combined with LC is an effective treatment for acute complicated cholecystitis, especially in elderly patients or those with serious comorbidities. To some extent, the curative effect of this method can be considered superior to that of emergency LC.
机译：腹腔镜胆囊切除术（LC）在急性胆囊炎中的适用性存在争议，尤其是严重的胆囊炎患者。最近，许多非必要的部门表明了对经皮转发胆囊引流（PTGBD）的偏好，但外科医生认为LC作为胆囊炎的最终治疗选择。与急诊LC（E-LC）相比，该分析评估了PTGBD与LC组合的疗效。我们回顾性分析了86例急性复杂性胆囊炎患者的临床资料。将患者分为两组，因为接受E-LC和接受PTGBD与LC（PTGBD + LC）结合的那些，以及基线特征，围手术期数据和手术参数进行了检查，以检查杂项差异。研究组的基线特征类似。但是，虽然操作持续时间（P = 0.12）和术后医院停留（P = 0.39）没有证据差异显着差异，但PTGBD + LC组的结果明显比E-LC组在失血方面具有显着更好的结果（P <0.05 ），腹膜排水持续时间（P <0.05），术后恢复口服摄入量（P <0.05）。此外，在E-LC组中转化为开放手术，LC和死亡率的并发症。 PTGBD联合LC是急性复杂性胆囊炎的有效治疗，特别是在老年患者或具有严重合并症的患者中。在某种程度上，这种方法的疗效可以被认为优于紧急LC。

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