한국간담췌외과학회지 (Annals of Hepato-Biliary-Pancreatic Surgery)

  • 제15권1호
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  • Pages.28-34
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  • 2011
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  • 2508-5778(pISSN)
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  • 2508-5859(eISSN)
한국간담췌외과학회 (The Korean Association of Hepato-Biliary-Pancreatic Surgery)
권호 표지

70세 이상의 급성 담낭염 환자에서 조기 복강경 담낭절제술과 경피적담낭조루술 후 지연 담낭절제술의 임상적 결과의 비교

Comparison of Clinical Result between Early Laparoscopic Cholecystectomy and Delayed Laparoscopic Cholecystectomy after Percutaneous Transhepatic Gallbladder Drainage (PTGBFD) in more than 70 Years Old Patients with Acute Cholecystitis

  • 김소희 (원광대학교 의과대학 외과학교실, 간담췌분과) ;
  • 정금오 (원광대학교 의과대학 외과학교실, 간담췌분과) ;
  • 채권묵 (원광대학교 의과대학 외과학교실, 간담췌분과) ;
  • 오정택 (원광대학교 의과대학 외과학교실, 간담췌분과) ;
  • 박동은 (원광대학교 의과대학 외과학교실, 간담췌분과)
  • Kim, So Hee (Department of Surgery, Division of Hepatobiliary Surgery, Wonkwang University College of Medicine) ;
  • Jung, Gum O (Department of Surgery, Division of Hepatobiliary Surgery, Wonkwang University College of Medicine) ;
  • Chae, Kwon Mook (Department of Surgery, Division of Hepatobiliary Surgery, Wonkwang University College of Medicine) ;
  • Oh, Jung Taek (Department of Surgery, Division of Hepatobiliary Surgery, Wonkwang University College of Medicine) ;
  • Park, Dong Eun (Department of Surgery, Division of Hepatobiliary Surgery, Wonkwang University College of Medicine)
  • 발행 : 2011.02.28
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: Operative management of acute cholecystitis in aged patients has been shown to have relatively higher morbidity and mortality. The aim of this study was to determine appropriate management protocols for acute cholecystitis in those more than 70 years old. Methods: From May 2003 to Dec 2009, we performed this study of patients over 70 years old that were diagnosed with acute cholecystitis (n=257). We excluded patients that had a hepatobilliary malignancy, a previous laparotomy history, secondary cholecystitis, or a high operative risk factor (n=78). Eligible participants were divided into two groups according to the first management of acute cholecystitis. One hundred two of the 179 (group A) had undergone a laparoscopic cholecystectomy (LC) or open cholecystectomy (OC) within 48 hr after arriving at the emergency room; 77 of the 179 (group 2) had PTGBD done as the first management protocol. We divided group 2 into group C (n=47) and D (n=30) according to cholecystectomy or not. We compared clinical outcomes of the two groups. Results: The mean age of patients was 77.5 years old (102 for Group A and 77 for Group B. Univariant analysis of pre-operative clinical findings between groups A and B showed a significant difference only in age and in type of acute cholecystitis, However, the pre-operative co-morbidity of group B was significantly higher than that for group A. Comparing postoperative results between groups A and C, postoperative complications, open conversion rate, and mortality after cholecystectomy were not significantly different. Conclusion: PTGBD could be considered as appropriate management in aged patients with acute cholecystitis. Moreover, PTGBD can reduce unnecessary cholecytectomies.

키워드

참고문헌

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