关键词: 急性结石性胆囊炎, 腹腔镜下胆囊切除术, 手术时机

Abstract: Objective To determine the appropriate time to perform laparoscopic cholecystectomy (LC) for acute calculous cholecystitis.Methods The clinical data of 125 patients with acute calculous cholecystitis who underwent LC between Jan.2018 and Dec.2021 were retrospectively analyzed.According to the interval time from symptom onset to operation,all patients were divided into 2 groups:immediate group (43 cases) who underwent LC within 24 hours and delayed group (82 cases) who underwent LC in 25-72h.The operation time,intraoperative blood loss,conversion to laparotomy,postoperative complications,postoperative hospitalization days and hospitalization expenses between the two groups were compared Results  The operation time,intraoperative blood loss of immediate group were lower than those of delayed group [50(45,65)min vs 65(55,95)min,10(10,20)ml vs 20(10,30)ml,P<0.05].There were no significant differences between the two groups with respect to incision infection,bile leak and biliary duct injury (4.7% vs 13.4%,2.3% vs 2.4%,2.3% vs 1.2%,P>0.05),but the total rate of postoperative complications in immediate group reduced significantly (9.3% vs 29.3%,P<0.05).No mortality occurred in either group.Both of postoperative hospitalization days and direct medical costs reduced in immediate group[5(5,7)d vs 7(6,7)d,6503(6231,7749)yuan vs 7056(6448,9105)yuan,P<0.05].Conclusion LC for the operable patient with acute calculous cholecystitis,during 24 h from onset of symptom,significantly reduced the operation time,intraoperative blood loss and postoperative hospital stay without increasing the rate of bile leak and biliary duct injury.

Key words: acute calculous cholecystitis, laparoscopic cholecystectomy, the timing of surgery