Safety and efficacy of early laparoscopic cholecystectomy for severe acute cholecystitis in EGS grade Ⅲ and above
Objective To explore the safety and efficacy of early laparoscopic cholecystectomy(LC)for severe acute cholecystitis in emergency general surgery(EGS)grade Ⅲ and above.Methods A total of 1,381 patients with acute cholecystitis underwent LC from January 2017 to June 2022.They were divided into two groups of severe(n=112)and general(n=1 269)according to disease severity.Two groups were compared in terms of preoperative general profiles,operative duration,intraoperative blood loss,intraoperative laparotomy rate,postoperative transfer rate into intensive care unit(ICU),perioperative mortality,postoperative drainage,postoperative hospital stay and complication rate.Results Compared to general group,there were increases in operative duration[(100.54±22.23)vs.(61.31±10.48)min],intraoperative blood loss[40.00(20.00,60.00)vs.5.00(5.00,10.00)mL],postoperative drainage[100.00(60.00,152.50)vs 30.00(20.00,40.00)mL]and postoperative hospital stay[(7.31±2.68)vs.(4.03±1.23)day].There were statistically significant differences(P<0.05);rate of conversion into open abdomen in intensive care group was 3.57％(P=0.208),rate of postoperative transfer to ICU 4.46％(P=0.297),perioperative mortality rate 0 and the incidence of complications was 7.14％(P=0.133).There was no statistically significant difference with general group.Conclusion Early LC of severe acute cholecystitis of EGS grade Ⅲ and above does not increase the incidence of postoperative complications.It is relatively safe and effective for severe acute cholecystitis.
Acute cholecystitisLaparoscopic cholecystectomyEmergency general surgerySafety
万方数据
维普
