Title : Optimal timing of Percutaneous Transhepatic Gallbladder Drainage (PTGBD) in High-Risk cute cholecystitis patients and Its impact on elective Laparoscopic Cholecystectomy (LC)
Abstract:
Aim: To compare the effect of the timing of Percutaneous Transhepatic Gallbladder Drainage (PTGBD) intervention on the difficulty of elective Laparoscopic cholecystectomy (LC) in high-risk patients with acute cholecystitis.
Methods: A retrospective analysis was used to collect data from the First Affiliated Hospital of Xinjiang Medical University. Clinical data of patients treated for acute cholestatic PTGBD between 2017 and 2022 was collected. Thirty cases were included in the early intervention group (≤2 days) and 36 cases in the late intervention group (>2 days). The reasons for tube placement, tube placement-related complications, surgical difficulty, and postoperative pathological findings were compared between the two groups.
Results: There were no statistically significant differences between the two groups in terms of age at admission or comorbidities. However, significant differences were observed in complications related to time (P=0.001), intraoperative blood loss (P=0.017), severe adhesions (P=0.001) and the conversion rate to open surgery (P=0.042). The Spearman's correlation coefficient between the interval time from onset and conversion was 0.25 (P=0.043).
Conclusion: PTGBD performed within two days of symptom onset may reduce the difficulty of surgery. The conversion in performing LC after PTGBD in patients with acute cholecystitis is positively correlated with the time between performing PTGBD.
Keywords: Acute cholecystitis, Percutaneous transhepatic gallbladder drainage, Laparoscopic cholecystectomy
