Timing Of The Laparoscopic Cholecystectomy After Percutaneous Transhepatic Gallbladder Drainage In The Treatment Of Acute Calculous Cholecystitis

1.Objective:This study compared the clinical effects of laparoscopic cholecystectomy(LC)at different time intervals after percutaneous transhepatic gallbladder drainage(PTGD)treatment in patients with acute calculous cholecystitis(ACC).To analyze and discuss the most appropriate time for LC treatment,so as to provide clinical reference for reducing patients' burden and improving their quality of life.2.Methods:All case data of ACC patients who were treated with PTGD prior to LC at different time intervals during the continuous period from July 2009 to July 2017 in the department of hepatobiliary surgery and interventional surgery of our hospital were collected and analyzed.According to the inclusion criteria and exclusion criteria,74 patients with ACC were selected as subjects.The interval of sequential LC was divided into three groups.The first group(31 cases)had LC interval within 4 weeks.In the second group(22 cases),the LC interval was 4-8weeks.In the third group(21 cases),the LC interval was greater than 8 weeks.The gallbladder wall thickness and surrounding inflammation,operation time,intraoperative bleeding,laparoscopic laparotomy percentage,mean postoperative hospital stay and expense were compared among the three groups.By using the statistical software SPSS 21.0 handle all clinical data,three sets of data are compared to each other,selecting the average ± standard deviation.The measurement data was analyzed by t test analysis;The count data were statistically analyzed by Chi-square test;and 0.05 is the threshold forstatistical significance.3.Results:Patients in the second group with a sequential LC interval of 4-8 weeks were superior to those in the first group(<4 weeks)and the third group(>8 weeks)in terms of operation time,intraoperative blood loss,hospitalization time and total hospitalization cost,with statistically significant differences(P<0.05).4.ConclusionAfter PTGD treatment,ACC patients receive LC surgery within 4-8 weeks after surgery,which can not only reduce the difficulty of operation,reduce the risk of surgery,but also shorten the hospitalization time and reduce the hospitalization cost.