早期急性胆囊炎腹腔镜胆囊切除术的时间

早期急性胆囊炎腹腔镜胆囊切除术的时间

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Timing of Early Laparoscopic Cholecystectomy for Acute Cholecystitis
Author: Al-Mulhim, Abdulmohsen A.
Source: JSLS, Journal of the Society of Laparoendoscopic Surgeons, Volume 12, Number 3, July - September 2008 , pp. 282-287(6)
Publisher: Society of Laparoendoscopic Surgeons

Abstract:
Objective: Although many surgeons advocate early laparoscopic cholecystectomy (LC) in acute cholecystitis, debate still exists regarding its optimal timing. This study compares the outcome of LC performed within and after 72 hours of admission in patients with acute cholecystitis.
Methods: Between January 2001 and December 2006, LC was performed in 196 consecutive patients with acute cholecystitis. Laparoscopic cholecystectomy was performed within 72 hours of admission in 82 patients (group 1) and after 72 hours in 114 patients (group 2). Data were collected prospectively.
Results: Both groups were matched in terms of age, sex, body mass index, fever, white blood cell count, and ultrasound findings. The overall conversion rate was 5%. No significant difference existed in conversion rates between group 1 (2.4%) and group 2 (7%) (P=0.3). The operation time (105 versus 126 minutes, P=0.008), complications (0% versus 6%, P=0.02), and total hospital stay (5 versus 12 days, P<0.001) were significantly reduced in group 1. No deaths occurred in this study.
Conclusion: Early LC can be performed safely in most patients with acute cholecystitis, but we recommend intervention within 72 hours of admission to minimize the complication rate and shorten the operation time and total hospital stay.

摘要：
目的：尽管许多医生主张在急性胆囊炎早期腹腔镜胆囊切除术（LC），的辩论依然存在，关于它的最佳时机。这项研究比较的结果LC内进行后72小时内入院的急性胆囊炎患者。
方法： 2001年1月到2006年12月，在196例急性胆囊炎LC进行。腹腔镜胆囊切除术在72小时内入院的82例患者（第1组），72小时后，在114例（第2组）。数据收集。
结果：两组均匹配的年龄，性别，身体质量指数，发热，白细胞计数，超声检查。整体转换率为5％。1组（2.4％）和第2组（7％）（P = 0.3）之间的转换率无显着差异存在。第1组手术时间（105比126分钟，P = 0.008），并发症（0％和6％，P = 0.02），总住院天数（5天与12天，P <0.001）显着降低。在这项研究中无死亡病例。
结论：早期LC可以安全地执行，在大多数急性胆囊炎患者，但我们建议在72小时内入院的干预，以尽量减少并发症的发生率，缩短了手术时间，总住院。

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