关键词: 急性胆囊炎, 经皮经肝胆囊穿刺引流术, 腹腔镜胆囊切除术, 手术时机, 治疗

Abstract: Objective The aim of this study was to compare the efficacy and safety of early and late sequential percutaneous trans-hepatic gallbladder drainage (PTGBD) and laparoscopic cholecystectomy (LC) for the treatment of patients with acute cholecystitis. Methods 145 patients with acute cholecystitis were admitted to our hospital between March 2019 and June 2020, 70 patients received PTGBD within seven days after onset of the disease and sequential LC (early PTGBD), and other 75 patients received PTGBD seven days after onset of the disease and sequential LC (lately PTGBD). Serum C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) levels were detected by ELISA. Results During LC, the blood loss in the lately PTGBD group was (26.8±9.3) mL, significantly less than [(46.12±16.3) mL, P<0.05] in the early PTGBD group, the operation time was (67.3±9.2) min, significantly shorter than [(83.2) ±8.3) min, P<0.05], the anal exhaust time was (22.5±5.9) h, significantly shorter than [(28.2±6.2)h, P<0.05], and the abdominal drainage time was (3.3±1.1) d, significantly shorter than [(6.6±1.3) d, P<0.05] in the early PTGBD group; serum aspartate aminotransferase and alanine aminotransferase levels in the lately PTGBD group were significantly lower than those in the early PTGBD group (P＜0.05), and serum CRP, IL-6 and TNF-α levels in the lately PTGBD group were significantly lower than those in the early PTGBD group (P＜0.05); the incidence of postoperative complications, such as bile leak and infections in the lately PTGBD was 5.3%, significantly lower than 20.0% in the early PTGBD group (P<0.05). Conclusion The late PTGBD and sequential LC in dealing with patients with acute cholecystitis is efficacious and safe, with less post-operational complications.

Key words: Acute cholecystitis, Percutaneous trans-hepatic gallbladder drainage, Laparoscopic cholecystectomy, Surgery