[Emergency cholecystectomy versus percutaneous transhepatic gallbladder drainage followed by delayed cholecystectomy in patients with moderate acute cholecystitis]

Abstract

Objective: To analysis the curative effect of emergency cholecystectomy (EC) and percutaneous transhepatic gallbladder drainage (PTGBD) followed by delayed cholecystectomy (DC) on the patients with moderate acute cholecystitis. Methods: The perioperative dataof patients in EC group (n=47) and in PTGBD-DC group (n=49) were compared retrospectively. Results: Compared to PTGBD+ DC group, EC patients had a significantly more postoperative abdominal drainage time [(9.0±12.9) vs (3.4±2.1) days, P=0.041], more postoperative hospital stay after cholecystectomy [(8.2±3.2) vs (5.1±1.8) days, P=0.004], more intraoperative bleeding [(101±125) vs (33±37) ml, P=0.003], more patients of LC conversion to open cholecystectomy (OC) (19.1% vs 4.1%, P=0.021) and more patients of OC(14.9% vs 0, P=0.005). Also, there were higher incidence of respiratory failure(14.8% vs 2.0%, P=0.029), and admission for ICU(21.3% vs 2.0 %, P=0.003). Also, patients of total OC in non-biliary surgeons group were more than that of biliary surgeons group statistically(63.2% vs 14.3 %, P=0.001). Conclusion: PTGBD followed by DC in the treatment of moderate acute cholecystitis was better than EC, especially in patients with complicated comorbidities and in non-biliary surgeons.

Keywords: Delayed cholecystectomy; Emergency cholecystectomy; Moderate acute cholecystitis; Percutaneous transhepatic gallbladder drainage.