Annals of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회지)

The Korean Association of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회)
권호 표지

Clinical Benefits of Preoperative Percutaneous Transhepatic Gallbladder Drainage in Patients Older than Sixty with Acute Cholecystitis

60세 이상 고령의 급성 담낭염 환자에 대한 수술전 경피적 담낭 배액술의 임상적 유용성

  • Kim, Sung-Won (Department of Surgery, Kangwon National University School of Medicine) ;
  • Hong, Seong-Kweon (Department of Surgery, Kangwon National University School of Medicine) ;
  • Kim, Yang-Hei (Department of Surgery, Kangwon National University School of Medicine) ;
  • Park, Seung-Bae (Department of Surgery, Kangwon National University School of Medicine) ;
  • Rho, Hye-Rin (Department of Surgery, Kangwon National University School of Medicine) ;
  • Chae, Gi-Bong (Department of Surgery, Kangwon National University School of Medicine)
  • 김성원 (강원대학교 의학전문대학원 외과학교실) ;
  • 홍성권 (강원대학교 의학전문대학원 외과학교실) ;
  • 김양희 (강원대학교 의학전문대학원 외과학교실) ;
  • 박승배 (강원대학교 의학전문대학원 외과학교실) ;
  • 노혜린 (강원대학교 의학전문대학원 외과학교실) ;
  • 채기봉 (강원대학교 의학전문대학원 외과학교실)
  • Published : 2010.09.30
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Abstract

Purpose: The purpose of this study was to evaluate the clinical benefits of preoperative percutaneous transhepatic drainage (PTGBD), especially regarding morbidity and mortality, in patients aged 60 or older with acute cholecystitis. Methods: A retrospective study was done on a series of elderly patients (>60 years old; n=132) who had been diagnosed between January 2007 and December 2009 as having acute cholecystitis. The patients were divided into 4 groups; cases in which only laparoscopic cholecystectomy (LC) was done (Group 1, n=84), cases in which LC was done after preoperative PTGBD (Group 2, n=15), cases in which only open cholecystectomy was done (Group 3, n=23), and cases in which open cholecystectomy was done after preoperative PTGBD (Group 4, n=10). We analyzed between group differences in surgical outcomes including periods of postoperative fast and postoperative hospital stay, OP. morbidity, and open conversion rate. Results: Patients in Group 1 had fewer underlying medical problems and lower ASA scores than patients in groups 2, 3, or 4 (p<0.05). Mean operating time in Group 2 (113.66${\pm}$107.5 min) was significantly longer than in group 1 (72.02.9${\pm}$34.2 min) (p<0.05) and the open conversion rate was higher (8.33% vs 26.67%). But, blood loss (ml) and OP time in Group 2 were lower than in Group 3 or 4 (p<0.001). Postoperative recovery progression (periods of postoperative fasting and length of postoperative hospital stay) of Group 2 were better than in groups 3 or 4 (p<0.001). Conclusion: Pre-operative PTGBD procedures in elderly patients with acute cholecystitis is a good clinical option as a pretreatment to a cholecystitis operation.

Keywords

References

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