[Clinical and economic aspects of laparoscopic surgery for acute cholecystitis in delayed presentation].

Autor:	Panin SI; Volgograd State Medical University, Volgograd, Russia.; Volgograd Regional Clinical Hospital No. 1, Volgograd, Russia., Akinchits AN; Volgograd State Medical University, Volgograd, Russia., Bykov AV; Volgograd State Medical University, Volgograd, Russia., Chepurina NG; Volgograd State Medical University, Volgograd, Russia., Kushniruk NE; Volgograd Regional Clinical Hospital No. 1, Volgograd, Russia., Durmyshev DA; Volgograd Regional Clinical Hospital No. 1, Volgograd, Russia., Us OA; Volgograd State Medical University, Volgograd, Russia., Suvorov VA; Volgograd State Medical University, Volgograd, Russia.
Jazyk:	ruština
Zdroj:	Khirurgiia [Khirurgiia (Mosk)] 2023 (12), pp. 7-13.
DOI:	10.17116/hirurgia20231217
Abstrakt:	Objective: To study the clinical and economic features of laparoscopic surgery for acute cholecystitis in delayed presentation. Material and Methods: A prospective non-randomized study (2020-2021) included 101 patients (73.2% ( n =74) men and 26.8% ( n =27) women, mean age 58±14.9 years) with acute cholecystitis who underwent laparoscopic cholecystectomy. Cost-effectiveness analysis of laparoscopic cholecystectomy at various periods after clinical manifestation was performed. Results: Surgical treatment within 72 hours was performed in 15% ( n =16) of cases (group 1), within 4-10 days - in 57.5% ( n =58) (group 2), after 10 days - in 26.7% ( n =27) of patients (group 3). Overall incidence of postoperative complications was 2.9%, postoperative mortality - 1.9% (two patients died from widespread peritonitis). Surgery time was 70 [65-83], 85 [69-110] and 115 [80-125] min (H=15.55, p <0.001), hospital-stay - 6 [5-7], 9 [7-10] and 11 [7-14] days, respectively (H=21.86, p <0.001). Cost of direct (medical and non-medical) treatment amounted to 29484 [27 509-33 885], 41265 [34 306-48 301] and 50591 [37 069-62 483] rubles, respectively (H=29.71, p <0.001)). Conclusion: Delayed hospitalization and surgical treatment of acute cholecystitis after 72 hours are accompanied by higher treatment costs by 29% in the period up to 10 days and by 58% after 10 days. These results require further validation and adjustment in large samples.
Databáze:	MEDLINE
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