|
KMID : 0978820030060010015
|
|
Journal of the Korean Society of Endoscopic & Laparoscopic Surgeons
2003 Volume.6 No. 1 p.15 ~ p.21
|
|
|
Laparoscopic Cholecystectomy in Acute Cholecystitis-Early Versus Delayed, Preceeding Versus Not Preceeding PGBD
|
|
Park Sang-Hwan
Chu Chong-Woo
Kim Hyung-Chul
|
|
|
Abstract
|
|
|
Purpose: When laparoscopic cholecystectomy (LC) was introduced, acute cholecystitis (AC) was considered a relative contraindication to its use. As experience has been gained, LC is no more contraindication in AC. However, several debates are presented in its application in AC. This study was proceeded to prove the safety of LC, to compare the superiority early and delayed LC, and to evaluate the necessity of PTGBD for the treatment of AC.
Methods: Total 110 patients of AC underwent LC by one surgeon in the Department of Surgery, Soon Chun Hyang University Hospital, Korea from Feb. 2001 to Dec. 2002. Their medical records were retrospectively reviewed. We compared between PTGBD group and non-PTGBD group and between early group (LC within 7 days of admission) and delayed group (LC after 7 days of admission).
Results: There was no significant difference between early group and delayed group in the patients profile. The results of surgery in the two groups showed that delayed operation did not significantly affect operating time, conversion rate, complication rate, or postoperative hospital stay, but significantly increased total hospital stay and conversion to open surgery was required in only one case of early group and common bile duct injury was never developed. The patients who underwent PTGBD were somewhat complicated clinically comparing with those who didnt proceed PTGBD. However, there was no significant difference between the two groups. The results of surgery in two groups showed that PTGBD did not affect operating time, conversion rate, complication rate, or postoperative hospital stay, but significantly increased total hospital stay.
Conclusion: LC for AC can be safe in experienced hands and should be done immediately after the diagnosis. PTGBD may be limited to higher risk groups of AC patients. Severity of cholecystitis should not be considered as the only indication of PTGBD.
|
|
|
KEYWORD
|
|
|
Acute cholecystitis, Laparoscopic cholecystitis, PTGBD
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
 
|
|