Abstract: Objective The purpose of this study was to observe the efficacy of percutaneous transhepatic gallbladder drainage (PTGD) and sequential laparoscopic cholecystectomy (LC) with preservation of main cystic artery in the treatment of patients with acute cholecystitis (AC). Methods 206 patients with AC were encountered in our hospital between October 2020 and September 2023, and were randomly divided into control (n=103) and observation group (n=103). The patients in the control group underwent PTGD and sequential conventional LC, and those in the observation group underwent PTGD and sequential LC with preservation of main cystic artery. Serum C-reactive protein (CRP), interleukin-6 (IL-6) , tumor necrosis factor (TNF-α), plasma cortisol (Cor) and norepinephrine (NE) levels were measured by ELISA. Results The operation time in the observation group was (56.5±7.2)min, much longer than [(44.3±10.4)min,P＜0.05], while the intraoperative blood loss was (16.5±3.2)ml, much less than [(67.4±14.5)ml, P＜0.05] in the control; there were no significant differences as respect to serum liver function tests before and after the operation between the two groups (P>0.05); five days after operation, serum CRP, IL-6, TNF-α and Cor levels in the observation were (18.5±2.3)mg/L, (14.5±12.3)mmol/L, (12.1±6.1)mmol/L and (56.5±17.1)ng/mL, all significantly lower than [(27.4±25.4)mg/L, (29.6±18.5)mmol/L, (25.1±8.1)m mol/L and (79.4±30.2)ng/mL, respectively, P＜0.05] in the control group; post-operationally, there was no significant difference respect to complications, such as incision infection, bile leakage and biliary injuries, between the two groups (4.9% vs. 5.8%, P>0.05). Conclusion The PTGD and sequential LC with preservation of main cystic artery could effectively reduce the intraoperative blood loss, and warrants further clinical investigation.

Key words: Acute cholecystitis, Percutaneous transhepatic gallbladder drainage, Preservation of main cystic artery, Laparoscopic cholecystectomy, Therapy