穿孔胆囊炎早期与间隔胆囊切除术后的结果:一个多中心队列研究
Janelle Cyprich1, Isabela Sandigo-Saballos1, Angela Neville1
1Division of Trauma/Acute Care Surgery/Surgical Critical Care, Harbor-UCLA Medical Center, Torrance, CA, USA.
American journal of surgery
|July 25, 2025
概括
胆囊穿孔的早期胆囊切除术 (EC) 是安全的,并且与更好的结果有关. 与间歇胆囊切除术 (IC) 相比,这种方法导致并发症减少和住院时间缩短.
科学领域:
- 胃肠病学 胃肠病学
- 外科手术的结果
- 胆囊疾病 胆囊疾病
背景情况:
- 胆囊穿孔是一种罕见但严重的疾病,具有显著的发病率.
- 穿孔胆囊炎中胆囊切除术的最佳时间仍然是争论的主题.
- 早期干预与延迟手术对患者的结果产生影响.
研究的目的:
- 为了比较早期 (同住) 与间隔 (延迟) 胆囊切除术在患有穿孔胆囊炎的患者中的结果.
- 确定早期胆囊切除术是否与提高安全性和减少并发症有关.
- 分析两个手术时间组之间的手术细节和短期结果.
主要方法:
- 在2014年至2023年期间,对230名因穿孔胆囊炎接受胆囊切除术的患者进行了多机构的回顾性审查.
- 早期胆囊切除术 (EC) 和间歇胆囊切除术 (IC) 组之间的表现特征,手术细节和短期结果的比较.
- 统计分析以确定结果的显著差异,包括手术方法,感染和住院.
主要成果:
- 87.4%的患者接受了早期胆囊切除术 (EC),而12.6%的患者接受了间隔胆囊切除术 (IC).
- 接受IC的患者更有可能需要开放式手术 (55.2%vs35.3%),并患上手术部位感染 (17.2%vs4.0%).
- 间隔胆囊切除术与较长的总住院时间有关 (中位数为8天与5天).
结论:
- 对穿孔胆囊炎的早期胆囊切除术是一种安全的,可能更好的方法.
- 与IC相比,EC与开放性手术和手术部位感染的可能性降低.
- 选择早期胆囊切除术可能会导致穿孔胆囊炎患者的整体住院时间缩短.
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