在急性胆囊炎中进行腹腔镜胆囊切除术的最佳时间:单中心研究
Yasin Güneş1, Emre Teke2, Mehmet T Aydın1
1General Surgery, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, TUR.
Cureus
|June 14, 2023
概括
建议对急性胆囊炎 (AC) 进行早期腹腔镜胆囊切除术 (ELC). 与长期或延迟的手术相比,即时ELC (ILC) 显著减少了住院时间,最大限度地减少了复发性攻击.
科学领域:
- 胃肠病学 胃肠病学
- 手术创新 在外科创新.
- 临床结果 临床结果
背景情况:
- 急性胆囊炎 (AC) 的管理通常涉及腹腔镜胆囊切除术 (LC).
- 在AC中LC的最佳时间,特别是早期与延迟,仍然是临床辩论的主题.
- 延迟腹腔镜胆囊切除术 (DLC) 是一种普遍的方法,但与早期干预相比,它的有效性受到质疑.
研究的目的:
- 为了确定腹腔镜胆囊切除术在被诊断为急性胆囊炎的患者的最佳时间.
- 为了比较AC的不同手术时间组的术后结果和住院时间.
主要方法:
- 在2014年至2020年期间,对178名接受AC手术的患者进行了回顾性审查.
- 患者被分为三个组:立即腹腔镜胆囊切除术 (ILC),延长的早期腹腔镜胆囊切除术 (pELC) 和延迟的腹腔镜胆囊切除术 (DLC).
- 分析包括人口统计,实验室,放射学数据和术后结果.
主要成果:
- 63名患者进行了立即腹腔镜胆囊切除术 (ILC),27名患者进行了延长的ELC (pELC),88名患者进行了延迟的LC (DLC).
- 术后的结果,不包括停留时间,在所有组中都是可比的.
- 在pELC和DLC组的总住院时间显著更长 (p<0.05),在pELC组的术后住院时间更长 (p<0.05).
- 值得注意的是,在等待延迟手术的患者中,有17.7%的患者经历了反复的AC发作.
结论:
- 立即腹腔镜胆囊切除术 (ILC) 是急性胆囊炎 (AC) 的推手术时间.
- ILC提供了将整体住院时间降至最低的优势.
- 早期干预可以减少在延迟手术等待期间疾病复发的风险.
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