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Percutaneous transhepatic gallbladder drainage followed by elective laparoscopic cholecystectomy for patients with moderate to severe acute cholecystitis

Percutaneous transhepatic gallbladder drainage followed by laparoscopic cholecystectomy (PTGBD+LC) is one treatment option for patients with moderate to severe acute cholecystitis (AC). However, the impact of PTGBD on operative difficulties in performing LC is controversial. We designed this retrosp...

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Autores principales: Lee, Ryukyung, Ha, Heontak, Han, Young Seok, Kwon, Hyung Jun, Ryeom, Hunkyu, Chun, Jae Min
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5682837/
https://www.ncbi.nlm.nih.gov/pubmed/29095318
http://dx.doi.org/10.1097/MD.0000000000008533
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author Lee, Ryukyung
Ha, Heontak
Han, Young Seok
Kwon, Hyung Jun
Ryeom, Hunkyu
Chun, Jae Min
author_facet Lee, Ryukyung
Ha, Heontak
Han, Young Seok
Kwon, Hyung Jun
Ryeom, Hunkyu
Chun, Jae Min
author_sort Lee, Ryukyung
collection PubMed
description Percutaneous transhepatic gallbladder drainage followed by laparoscopic cholecystectomy (PTGBD+LC) is one treatment option for patients with moderate to severe acute cholecystitis (AC). However, the impact of PTGBD on operative difficulties in performing LC is controversial. We designed this retrospective study to clarify the surgical outcomes after PTGBD+LC for the management of patients with moderate to severe AC. The medical records of 85 patients who underwent LC for moderate to severe AC from January 2013 to September 2016 were evaluated. They were divided into 2 groups based on the type of management: group A received PTGBD+LC, and group B received LC without drainage. We compared the patient characteristics, laboratory data which were obtained immediately before surgery or PTGBD at index admission, and surgical outcomes between the 2 groups. We also evaluated possible predictive factors associated with prolonged operative duration after PTGBD+LC. Patients in group A were older and had more comorbidities than those in group B. The laboratory tests obtained at index admission in group A showed higher serum levels of C-reactive protein (CRP) and alkaline phosphatase, and lower albumin levels than those in group B. The surgical outcomes after LC were similar between the 2 groups. However, operative duration was significantly shorter in group A (P = .012). In group A, a higher serum level of CRP was a predictive factor for a prolonged operation (hazard ratio 1.126; 95% confidence interval 1.012–1.253; P = .029). In conclusion, PTGBD+LC can shorten the operative duration in patients with moderate to severe AC, which might improve surgical outcomes in elderly patients with comorbidities, and elevated CRP values predicted a prolonged operation after PTGBD.
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spelling pubmed-56828372017-11-28 Percutaneous transhepatic gallbladder drainage followed by elective laparoscopic cholecystectomy for patients with moderate to severe acute cholecystitis Lee, Ryukyung Ha, Heontak Han, Young Seok Kwon, Hyung Jun Ryeom, Hunkyu Chun, Jae Min Medicine (Baltimore) 7100 Percutaneous transhepatic gallbladder drainage followed by laparoscopic cholecystectomy (PTGBD+LC) is one treatment option for patients with moderate to severe acute cholecystitis (AC). However, the impact of PTGBD on operative difficulties in performing LC is controversial. We designed this retrospective study to clarify the surgical outcomes after PTGBD+LC for the management of patients with moderate to severe AC. The medical records of 85 patients who underwent LC for moderate to severe AC from January 2013 to September 2016 were evaluated. They were divided into 2 groups based on the type of management: group A received PTGBD+LC, and group B received LC without drainage. We compared the patient characteristics, laboratory data which were obtained immediately before surgery or PTGBD at index admission, and surgical outcomes between the 2 groups. We also evaluated possible predictive factors associated with prolonged operative duration after PTGBD+LC. Patients in group A were older and had more comorbidities than those in group B. The laboratory tests obtained at index admission in group A showed higher serum levels of C-reactive protein (CRP) and alkaline phosphatase, and lower albumin levels than those in group B. The surgical outcomes after LC were similar between the 2 groups. However, operative duration was significantly shorter in group A (P = .012). In group A, a higher serum level of CRP was a predictive factor for a prolonged operation (hazard ratio 1.126; 95% confidence interval 1.012–1.253; P = .029). In conclusion, PTGBD+LC can shorten the operative duration in patients with moderate to severe AC, which might improve surgical outcomes in elderly patients with comorbidities, and elevated CRP values predicted a prolonged operation after PTGBD. Wolters Kluwer Health 2017-11-03 /pmc/articles/PMC5682837/ /pubmed/29095318 http://dx.doi.org/10.1097/MD.0000000000008533 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Noncommercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle 7100
Lee, Ryukyung
Ha, Heontak
Han, Young Seok
Kwon, Hyung Jun
Ryeom, Hunkyu
Chun, Jae Min
Percutaneous transhepatic gallbladder drainage followed by elective laparoscopic cholecystectomy for patients with moderate to severe acute cholecystitis
title Percutaneous transhepatic gallbladder drainage followed by elective laparoscopic cholecystectomy for patients with moderate to severe acute cholecystitis
title_full Percutaneous transhepatic gallbladder drainage followed by elective laparoscopic cholecystectomy for patients with moderate to severe acute cholecystitis
title_fullStr Percutaneous transhepatic gallbladder drainage followed by elective laparoscopic cholecystectomy for patients with moderate to severe acute cholecystitis
title_full_unstemmed Percutaneous transhepatic gallbladder drainage followed by elective laparoscopic cholecystectomy for patients with moderate to severe acute cholecystitis
title_short Percutaneous transhepatic gallbladder drainage followed by elective laparoscopic cholecystectomy for patients with moderate to severe acute cholecystitis
title_sort percutaneous transhepatic gallbladder drainage followed by elective laparoscopic cholecystectomy for patients with moderate to severe acute cholecystitis
topic 7100
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5682837/
https://www.ncbi.nlm.nih.gov/pubmed/29095318
http://dx.doi.org/10.1097/MD.0000000000008533
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