Analysis Of The Criteria For Evaluating The Timing Of LC After PTGD

Objective To screen and validate the controversial indicators,establish an objective evaluation system,evaluate the timing of operation,and reduce the adverse effects of laparoscopic cholecystectomy.Through this study,the indications of laparoscopic cholecystectomy after percutaneous transhepatic gallbladder puncture and catheterization drainage were evaluated comprehensively,and the feasibility of establishing an evaluation system for the timing of laparoscopic cholecystectomy based on various indicators was verified,and the available predictive indicators were determined.Methods The data of patients with severe acute cholecystitis from July 2017 to January 2019 in Affiliated Hospital of Inner Mongolia Medical University were collected and studied.Laparoscopy was predicted according to the thickness of gallbladder wall,laboratory indexes(neutrophils,liver function indexes),nature of drainage bile,intraoperative adhesion of gallbladder triangle and whether or not the patients were complicated with chronic diseases before percutaneous transhepatic gallbladder puncture and catheterization.Opportunity for cholecystectomy.At the same time,the operation conditions of laparoscopic cholecystectomy were observed,including operation time,conversion rate to open surgery,intraoperative bleeding volume,complication rate and hospital stay after operation,to evaluate the degree of difficulty of operation,and then to verify the predictive role of various indicators.Results There was no death during or after operation in all patients.There was no significant difference in sex and age between groups.Bilirubin and white blood cell counts were significantly different before and after operation.The proportion of neutrophils was different among the three groups after laparoscopic cholecystectomy.Conclusion Percutaneous transhepatic gallbladder drainage combined with laparoscopic cholecystectomy is a safe,effective,reasonable and feasible treatment for severe acute cholecystitis.The predictive effect of neutrophil ratio is weak.Bilirubin content,white blood cell count,gallbladder wall thickness and bile properties have good predictive effect.Patients who meet the criteria of less than 3 can be re-treated in a short time.Laparoscopic cholecystectomy was performed.