Comparison of different surgical procedures in treating patients with acute calculous cholecystitis

Abstract

Objective To investigate the effect of different surgical procedures in treating patients with acute calculous cholecystitis. Methods A retrospective analysis were performed in 221 patients with acute calculous cholecystitis from January 2013 to June 2016 in our hospital, who were divided into laparoscopic cholecystectomy (LC) group (emergency LC, n=152), percutaneous transhepatic gallbladder drainage (PTGD) + LC group (n=46) and open cholecystectomy (OC) group (n=23). Baseline and clinical data were compared between three groups. Statistical analysis were performed by using SPSS19.0 statistical software. Measurement data such as perioperative indicators were expressed as mean±standard deviation and examined by using t-test and analysis of variance. The incidence of postoperative complications and baseline data were compared by using chi square test. A P value of <0.05 was considered as statistically significant difference. Results ⑴Age and severity of cholecystitis in PTGD+ LC group were significantly higher than those in other two groups respectively (P 0.05). ⑵Operation time in PTGD+ LC group was significantly higher than that in LC group, and total hospitalization time and hospitalization expenses in PTGD+ LC group were significantly higher than those in other two groups respectively (P 0.05). There was no significant difference of the incidence of postoperative complications between three groups (P>0.05). Conclusions For patients with acute calculous cholecystitis without obvious surgical contraindications, emergency LC is the preferred treatment method. For those who could not undergo emergency surgery, PTGD cuold be performed first, then considering the next step. Key words: Cholecystitis, Acute; Cholecystectomy, Laparoscopic; Gallstones; Cholecystectomy; Laparotomy