Purpose: The laparoscopic cholecystectomy (LC) has been accepted as the gold standard treatment for the acute cholecystitis presently. However, mortality, morbidity, open conversion rate, and complications still remain to be solved. This retrospective study was undertaken to evaluate the safety and effectiveness of percutaneous transhepatic gallbladder drainage (PTGBD) followed by LC in patients who have coexisting diseases or elderly patients who have systemic diseases.
Methods: We analyzed 127 patients who underwent laparoscopic cholecystectomy for acute cholecystitis between January 1999 and December 2003. Thirty six patients who underwent the percutaneous transhepatic gallbladder drainage (PTGBD) before laparoscopic cholecystectomy were classified into PTGBD group, 91 patients who underwent laparoscopic cholecystectomy directly were classified into non- PTGBD group.
Results: Compared with the non-PTGBD group, the PTGBD group had a higher frequency of coexisting disease (p=0.000) and their mean age was older than non-PTGBD group (p=0.029). and their ASA classification was worse than non -PTGBD group (p=0.000). the PTGBD group showed higher body temperature (p=0.019) and longer duration of hospitalization than early LC group (p=0.000). There were no significant differences in gender, conversion rate, duration of surgery, postoperative hospitalization days and postoperative complications between two groups.
Conclusion: Preoperative transhepatic gallbadder drainage is a safe and effective treatment modality in selected patients with acute cholecystitis,especially associated with old age and coexisting diseases
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