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Published on: September 13, 2022
Early versus delayed laparoscopic cholecystectomy after percutaneous transhepatic gallbladder drainage
In Woong Han1, Jin-Young Jang, Mee Joo Kang
1Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, South Korea.
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.
