Clinical Study Of Percutaneous Transhepatic Gallbladder Drainage In Patients With Moderate Acute Cholecystitis

Objective:We compared emergency cholecystectomy(EC)with percutaneous transhepatic gallbladder drainage(PTGBD)followed by delayed cholecystectomy(DC)In moderate acute cholecystitis patients.Methods:We retrospectively compare the perioperative date of patients in EC group(n=50)with that in PTGBD+DC group(n=54).Results:Compared to PTGBD+DC group,EC patients had a statistically more surgical time(116±39 vs 84±37 min,p=0.000),postoperative abdominal drainage time(8.7+12.6 vs 3.5±2.1 days,p=0.005),more postoperative hospital stay after cholecystectomy(8.2±3.2 vs 5.1±1.8 days,p=0.000),more intraoperative bleeding(97±123vs 33±37 ml,p=0.001),,more patients of LC conversion to open cholecystectomy(OC)(18%vs 3.7%,p=0.018)and more patients of OC(16%vs 0,p=0.002).Also,there a re higher incidence of respiratory failure(14%vs 1.9%,p=0.027),admission for ICU(20%vs 1.9%,p=0.003).there are statistically less complications about gallbladder drainage(8%vs 43%,P=0.005)in the group of the interval less than 2 months compared with the interval more than 2 months.Conclusion(s):PTGBD followed by DC in the treatment of moderate acute cholecystitis was better than EC,especially in patients with complicated comorbidities.Also,to avoiding the complications about gallbladder drainage,we recommend to perform the cholecystectomy at the interval less than 2 months.The interval can be prolonged when the patients are older or have more time of persistence of symptom before the surgical treatment.