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Early versus delayed laparoscopic cholecystectomy after percutaneous transhepatic gallbladder drainage
Author(s) -
Han In Woong,
Jang JinYoung,
Kang Mee Joo,
Lee Kyoung Bun,
Lee Seung Eun,
Kim SunWhe
Publication year - 2012
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1007/s00534-011-0458-6
Subject(s) - perioperative , percutaneous , medicine , gallbladder , laparoscopic cholecystectomy , cholecystectomy , acute cholecystitis , cholecystitis , surgery , general surgery , complication , group b
Background Percutaneous transhepatic gallbladder drainage (PTGBD) is a procedure to resolve acute cholecystitis (AC). It may decrease the technical difficulty of laparoscopic cholecystectomy (LC) and thus may facilitate successful surgery when a patients’ condition improves. However, the timing of LC after PTGBD remains controversial. Methods From 2004 to 2010, cholecystectomy after PTGBD was performed in 67 patients with AC. Group I members underwent LC within 72 h of PTGBD ( n = 21), whereas group II members underwent LC at more than 72 h after PTGBD ( n = 46). Results The open conversion rate was similar in the two groups. The perioperative complication rate was higher in group I than in group II, but with marginal significance (19.0 vs. 4.3%; p = 0.07). Mean operative time was longer in group I than in group II (79.3 ± 25.3 vs. 53.7 ± 45.3 min; p = 0.02). However, overall hospital stay was shorter in group I than in group II, but with marginal significance (10.8 ± 4.5 vs. 14.7 ± 9.3 days; p = 0.08). Conclusions Pros and cons were well balanced between the two groups. Decisions on the timing of cholecystectomy after PTGBD should be made based on considerations of patient condition, hospital facilities, and surgical experience.