在急性胆囊炎的保守治疗后, laparoscopic胆囊切除术的最佳时间
Yuta Enami1,2, Takeshi Aoki2, Kodai Tomioka1,2
1Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
Cancer diagnosis & prognosis
|September 6, 2023
概括
延迟腹腔镜胆囊切除术 (LC) 治疗急性胆囊炎超过90天可能会缩短手术时间和住院时间. 这种方法似乎还能在手术期间最大限度地减少并发症和转化率.
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:
- 2018年东京指南建议急性胆囊炎的早期手术.
- 由于患者或设施的限制,早期手术可能是不可行的,需要选择性手术.
- 对选择性腹腔镜胆囊切除术 (LC) 病例进行了回顾性分析.
研究的目的:
- 评估急性胆囊炎的延迟腹腔镜选择性胆囊切除术 (LC) 的结果.
- 在手术时间,住院时间和并发症率方面,比较早期与延迟的LC.
主要方法:
- 从2019年1月至2020年12月接受LC的345名患者的回顾性分析.
- 分析了83名LC患者在保守治疗后的3天内进行的LC.
- 患者被分为早期 (4-90天) 和延迟 (≥91天) 组.
主要成果:
- 与早期组相比,延迟组的手术时间 (91.2分 vs. 117分钟) 和术后住院时间 (3.4天 vs. 5.9天) 显著缩短.
- 没有观察到转化或并发症率的显著差异,但在延迟组中,这些倾向于减少.
- 值得注意的是,在延迟组中没有出现并发症.
结论:
- 在急性胆囊炎的选择性LC延迟至少91天后,可以减少手术时间和住院时间.
- 延迟的LC可能会导致更少的并发症和更低的转化率.
- 这种策略提供了一个潜在的更安全的替代品,当早期手术是不可行的.
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