J Minim Invasive Surg.  2016 Jun;19(2):63-69. 10.7602/jmis.2016.19.2.63.

The Benefits of Percutaneous Transhepatic Gallbladder Drainage prior to Laparoscopic Cholecystectomy for Acute Cholecystitis

Affiliations
  • 1Department of Surgery, National Medical Center, Seoul, Korea. spark479@unitel.co.kr

Abstract

PURPOSE
Several studies have reported that laparoscopic cholecystectomy with percutaneous transhepatic gallbladder drainage (PTGBD) is associated with a reduced duration of surgery and a lower rate of conversion to open laparotomy compared with laparoscopic cholecystectomy without PTGBD and delayed laparoscopic cholecystectomy after conservative therapy. However, these results are contradictory. This retrospective study investigated the safety and usefulness of laparoscopic cholecystectomy combined with pre-operative PTGBD in patients with acute cholecystitis.
METHODS
The clinicopathologic data and surgical outcomes of 101 patients who underwent laparoscopic cholecystectomy between January 2010 and September 2015 were reviewed retrospectively.
RESULTS
Patients in the PTGBD group vs. the non-PTGBD group were significantly older (mean age: 65.47±12.2 vs. 56.32±13.7; p=0.001). Underlying diseases were also significantly more common in the PTGBD group (75.4% vs. 45.5%; p=0.002). There were no significant differences between the two groups in terms of operative time, blood loss, rate of open conversion, postoperative oral intake, and postoperative hospital stay. Total hospital day was significantly longer in the PTGBD group (11.14±7.22 vs. 6.23±5.17; p=0.049). There was no significant difference in the postoperative complications between the two groups, and all patients in this study lived.
CONCLUSION
This study suggested that satisfactory results can be achieved with selective preoperative PTGBD in older and sicker patients with acute cholecystitis.

Keyword

Acute cholecystitis; Laparoscopic cholecystectomy; Percutaneous transhepatic gallbladder drainage (PTGBD)

MeSH Terms

Cholecystectomy, Laparoscopic*
Cholecystitis, Acute*
Drainage*
Gallbladder*
Humans
Laparotomy
Length of Stay
Operative Time
Postoperative Complications
Retrospective Studies
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