Abstract: Objective The aim of this study was to investigate selective laparoscopic cholecystectomy (LC) after ultrasound-guided percutaneous transhepatic gallbladder puncture drainage (UG-PTGD) in treatment of patients with acute calculous obstructive cholecystitis (ACOC). Methods A total of 109 patients with ACOC were encountered in our hospital between May 2020 and May 2024, and were randomly assigned to receive LC (control, n=54) or selective LC after UG-PTGD (observation, n=55). Serum tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP) levels were detected by ELISA. Results Operation time, intraoperative blood loss, postoperative drainage volume, anal exhaust time, extubation time and hospital stay in the observation group were (54.5±8.1)min, (33.8±7.9)mL,(18.5±2.9)mL,(21.5±4.2)h, (3.3±0.6)d and (4.5±1.5)d, all much less or shorter than [(72.6±11.4)min,(44.1±6.7)mL,(26.9±4.2)mL,(27.4±3.9)h,(4.8±0.7)d and (10.6±2.9)d, respectively, P＜0.05] in the control; post-operationally, serum AST and ALT levels were much lower than in the control (P＜0.05); serum TNF-α, IL-6 and CRP levels were (32.2±11.4)ng/mL, (116.7±12.3)pg/mL and (25.8±5.2)mg/L, all significantly lower than [(39.6±12.7)ng/mL, (127.1±19.2)pg/mL and (46.7±8.1)mg/L, respectively, P＜0.05] in the control; incidence of complications was 9.1%, much lower than 24.1%(P＜0.05) in the control group. Conclusion Emergent management by UG-PTGD, and thereafter selective LC in the treatment of patients with ACOC were safe, efficacious, which might be an alternative option in this clinical scenario.

Key words: Acute calculous obstructive cholecystitis, Ultrasound-guided percutaneous transhepatic gallbladder puncture drainage, Laparoscopic cholecystectomy, Therapy