Surgery today · 2025
Interval laparoscopic cholecystectomy for acute cholecystitis should be performed within approximately 1 week after gallbladder drainage.
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Nishimura Erica, Takano Kiminori, Fujisaki Hiroto, Muroi Takako, Hayashi Keita, Tajima Yuki, Hongo Kumiko, Nakagawa Motohito
Аннотация
PURPOSE: The optimal interval between gallbladder drainage for acute cholecystitis and laparoscopic cholecystectomy (LC) remains unclear. This study evaluated the ideal interval to perform LC after drainage from the perspectives of surgical difficulty and patient satisfaction.
METHODS: This retrospective study included patients who underwent LC after drainage at our institution between April 2016 and November 2023. The patients were divided into early surgery (ES) and delayed surgery (DS) groups. The surgical outcomes and surgical difficulty scores were compared between the groups.
RESULTS: A total of 72 patients (30 in the ES group and 42 in the DS group) were included. The median interval periods were 8 and 56 days in the ES and DS groups, respectively. Operative time, blood loss, and the incidence of postoperative complications were comparable between the groups. However, the rates of achieving a critical view of safety and avoiding conversion to open surgery were significantly higher in the ES group than in the DS group. Finally, scarring around Calot's triangle was significantly greater in the DS group than in the ES group. In addition, 19% of the patients in the DS group experienced cholecystitis recurrence, and 40% had tube-related complications during the interval period.
CONCLUSION: The results showed that interval LC should be performed relatively soon after drainage.
METHODS: This retrospective study included patients who underwent LC after drainage at our institution between April 2016 and November 2023. The patients were divided into early surgery (ES) and delayed surgery (DS) groups. The surgical outcomes and surgical difficulty scores were compared between the groups.
RESULTS: A total of 72 patients (30 in the ES group and 42 in the DS group) were included. The median interval periods were 8 and 56 days in the ES and DS groups, respectively. Operative time, blood loss, and the incidence of postoperative complications were comparable between the groups. However, the rates of achieving a critical view of safety and avoiding conversion to open surgery were significantly higher in the ES group than in the DS group. Finally, scarring around Calot's triangle was significantly greater in the DS group than in the ES group. In addition, 19% of the patients in the DS group experienced cholecystitis recurrence, and 40% had tube-related complications during the interval period.
CONCLUSION: The results showed that interval LC should be performed relatively soon after drainage.