Risk Factors For Emergency Laparoscopic CholecystectomyFor Grade ? Acute Cholecystitis

Purpose:To identify the risk factors for emergency laparoscopic cholecystectomy(LC)for treating grade II acute cholecystitis(AC)according to the Tokyo guidelines 2018.Method:130 patients who underwent emergency LC for treating grade II acute cholecystitis from 2015.1 to 2018.6 in China Medical University Shengjing Hospital were registered.Based on different surgeons and their Median operative time of LC,they were divided into easy LC group(n=68,52.3%)and difficult LC group(n=62,47.4%).All patients experienced the following conditions:(1)no percutaneous transhepatic gallbladder drainage(PTGBD)before;(2)no history of abdominal surgery;(3)no biliary duct stone or biliary pancreatitis;(4)no surgical contraindication;(5)no gallbladder cancer.Preoperative characteristics were analyzed.Results:In univariate analysis,risk factors included performed anti-inflammatory therapy before,Interval between symptom onset and operation,gallbladder wall thickness and the maximum cross-sectional area of gallbladder.In multivariate analysis and depend on receiver operating characteristic(ROC)curve and Youden's index,independent risk factors included the maximum cross-sectional area of gallbladders over 24.77cm~2[OR=1.076,95%CI:1.04~1.114,P<0.001].Conclusions:The operative time of LC was longer when the maximum cross-sectional area of gallbladder over 24.77cm~2.Thus,maybe PTGBD should be chosen rather than emergency LC in these patients.