Optimal timing of cholecystectomy after percutaneous gallbladder drainage for severe cholecystitis
| Autor: | Hiroo Naito, Daisuke Douchi, Koetsu Inoue, Tatsuya Ueno, Shinji Goto, Michinaga Takahashi, Chikashi Shibata, Orie Nishina, Kentaro Shima |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Percutaneous medicine.medical_treatment Cholecystitis Acute 03 medical and health sciences Postoperative Complications 0302 clinical medicine Internal medicine Cholecystitis medicine Acute cholecystitis Humans Cholecystectomy lcsh:RC799-869 Drainage Laparoscopy Percutaneous transhepatic gallbladder drainage Aged medicine.diagnostic_test business.industry Gallbladder General surgery Gastroenterology General Medicine Hepatology medicine.disease medicine.anatomical_structure 030220 oncology & carcinogenesis lcsh:Diseases of the digestive system. Gastroenterology Female 030211 gastroenterology & hepatology business Research Article |
| Zdroj: | BMC Gastroenterology BMC Gastroenterology, Vol 17, Iss 1, Pp 1-7 (2017) |
| ISSN: | 1471-230X |
| DOI: | 10.1186/s12876-017-0631-8 |
| Popis: | Background The Tokyo guideline for acute cholecystitis recommended percutaneous transhepatic gallbladder drainage followed by cholecystectomy for severe acute cholecystitis, but the optimal timing for the subsequent cholecystectomy remains controversial. Methods Sixty-seven patients who underwent either laparoscopic or open cholecystectomy after percutaneous transhepatic gallbladder drainage for severe acute cholecystitis were enrolled and divided into difficult cholecystectomy (group A) and non-difficult cholecystectomy (group B). Patients who had one of these conditions were placed in group A: 1) conversion from laparoscopic to open cholecystectomy; 2) subtotal cholecystectomy and/or mucoclasis; 3) necrotizing cholecystitis or pericholecystic abscess formation; 4) tight adhesions around the gallbladder neck; and 5) unsuccessfully treated using PTGBD. Preoperative characteristics and postoperative outcomes were analyzed. Results The interval between percutaneous transhepatic gallbladder drainage and cholecystectomy in Group B was longer than that in Group A (631 h vs. 325 h; p = 0.031). Postoperative complications occurred more frequently when the interval was less than 216 h compared to when it was more than 216 h (35.7 vs. 7.6%; p = 0.006). Conclusions Cholecystectomy for severe acute cholecystitis was technically difficult when performed within 216 h after percutaneous transhepatic gallbladder drainage. Electronic supplementary material The online version of this article (doi:10.1186/s12876-017-0631-8) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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