The Application Of LC In Acute Suppurative Cholecystitis And The Opportunity Of Operation

Objective By collecting case data of patients with acute suppurative cholecystitis who underwent laparoscopic cholecystectomy(LC)by the same surgeon in our hospital,we retrospectively analyzed the relationship between LC at different surgery opportunity and the surgical efficacy and postoperative recovery of patients,and exploring the value of LC in acute suppurative cholecystitis.Methods A total of 149 ASC cases with LC treatment performed by the same surgeon(Senior Surgeon)in the Hepatobiliary Surgery Department of Ningxia People's Hospital from June 2012 to June 2019 were collected as research objects,and relevant clinical data were collected according to the timing of the operation,Divided into early surgery group(time from onset to surgery <72h)76 cases,late surgery group(time from onset to surgery >72h)73cases,using statistical methods to compare preoperative conditions,intraoperative and intraoperative after the recovery situation.Results The amount of intraoperative bleeding in the early surgery group was significantly less than that in the late surgery group(30.000 ± 40.000 ml VS 50.000 ±75.000 ml P = 0.005);the operation time in the early surgery group was significantly less than the late surgery group(101.526±37.807minVS119.02±49.343 min P=0.016);The rate of subtotal cholecystectomy in the early surgery group was 11.8%(9/76)and that in the late surgery group was 32.9%(24/73).Compared with the early surgery group,the two groups were significantly less than the late surgery group(P=0.002);The incidence of postoperative complications in the early surgery group was 5.3%(1/76),and the late surgery group was19.2%(11/73).Compared with the early surgery group,the two groups were significantly lower than the late surgery group(P=0.002);the postoperative drainage tube placement time of the early surgery group was significantly lower than that of the late surgery group(3.000±1.458 d VS 5.000±3.000 d P=0.006);the hospitalization time of the early surgery group was significantly lower than that of the late surgery group(4.000±5.500 d VS 10.000±5.000 d P<0.001).Conclusion1.LC is feasible in patients with ASC.LC treatment within 72 hours of onset can shorten the operation time,reduce the amount of intraoperative bleeding and time of postoperative abdominal drainage tube placement,Shorten postoperative hospital stay,and the incidence of postoperative complications is lower,which is conducive to the rapid recovery of patients.2.For patients with ASC with an onset of more than 72 hours,LC is also feasible without absolute contraindications to surgery.However,the operation is difficult and high-risk and should be operated with caution.