Gao W, Zheng J, Bai JG, Han Z. Effect of surgical timing on postoperative outcomes in patients with acute cholecystitis after delayed percutaneous transhepatic gallbladder drainage. World J Gastrointest Surg 2024; 16(11): 3445-3452 [DOI: 10.4240/wjgs.v16.i11.3445]
Corresponding Author of This Article
Zhao Han, MD, Professor, Department of General Surgery, No. 215 Hospital of Shaanxi Nuclear Industry, No. 35 Weiyang West Road, Qindu District, Xianyang 712000, Shaanxi Province, China. hanzhao_004@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
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World J Gastrointest Surg. Nov 27, 2024; 16(11): 3445-3452 Published online Nov 27, 2024. doi: 10.4240/wjgs.v16.i11.3445
Table 1 Baseline characteristics of the two groups before percutaneous transhepatic gallbladder drainage, mean ± SD
Variables
Early LC group (n = 32)
Delayed LC group (n = 36)
P value
Sex (male/female)
18/14
20/16
0.954
Age (years)
65.4 ± 15.2
62.1 ± 17.3
0.823
BMI (kg/m2)
25.26 ± 4.28
24.36 ± 3.19
0.428
Etiology (with/without stone)
30/2
35/1
0.486
Grade of AC (II/III)
14/18
23/13
0.096
CCI (< 4/≥ 4)
15/17
14/22
0.506
ASA-PS class (< 3/≥ 3)
12/20
16/20
0.561
Time from symptom onset to PTGBD (days)
8.9 ± 1.1
9.2 ± 1.3
0.748
Table 2 Indications for percutaneous transhepatic gallbladder drainage catheterization in the patient groups, n (%)
Indications
Early LC group
Delayed LC group
P value
Septic shock
14 (43.8)
12 (33)
0.378
Gallbladder perforation
10 (31.3)
11 (30.6)
0.951
Progressive abdominal pain
5 (15.6)
8 (22.2)
0.490
Persistent high fever
2 (6.3)
3 (8.3)
0.743
Sepsis
1 (3.1)
2 (5.6)
0.626
Cardiovascular dysfunction
5 (15.6)
7 (19.4)
0.680
Neurological dysfunction
0 (0)
1 (2.7)
0.342
Respiratory dysfunction
6 (18.8)
11 (30.6)
0.262
Liver or kidney dysfunction
8 (25)
5 (13.0)
0.245
Coagulation disorders
1 (3.1)
0 (0)
0.285
Table 3 Percutaneous transhepatic gallbladder drainage catheterization complications in the patient groups, n (%)
Complications
Early LC group
Delayed LC group
P value
Catheter detachment
2 (6.3)
1 (2.8)
0.486
Bile leakage
2 (6.3)
2 (5.6)
0.903
Biliary peritonitis
1 (3.1)
1 (2.8)
0.933
Infection
0 (0.0)
1 (2.8)
0.342
Hemorrhage
1 (3.1)
0 (0.0)
0.285
Table 4 Surgical outcomes between the two groups of patients after PTGBD, mean ± SD
Outcome measures
Early LC group (n = 32)
Delayed LC group (n = 36)
P value
LC surgery time (minute)
108.3 ± 14.2
90.2 ± 12.2
< 0.001
Intraoperative blood loss (mL)
15.4 ± 5.1
16.0 ± 4.3
0.474
Operation (LC/ laparotomy)
21/11
32/4
0.021
Degree of adhesions (mild/severe)
20/12
33/3
0.004
Number of complications
9
2
0.012
Surgical site infection
3
1
0.248
Bile leakage
2
1
0.486
Hemorrhage
2
0
0.128
Pulmonary infection
1
0
0.285
Hyperamylasemia
1
0
0.285
Abdominal drainage tube placement time (day)
1.9 ± 0.7
2.0 ± 0.7
0.378
Postoperative hospital stay
9.1 ± 4.1
3.0 ± 0.9
< 0.001
PTGBD drainage tube placement time (day)
10.8 ± 1.6
19.8 ± 4.0
< 0.001
Pain index (0-10)
3.3 ± 1.3
3.7 ± 1.1
0.083
Patient satisfaction (%)
80.5 ± 11.5
85.3 ± 9.8
0.028
Total disease duration (day)
32.1 ± 5.3
33.2 ± 5.1
0.125
Total treatment costs (Yuan)
23570.9 ± 4996.1
21144.7 ± 2065.5
0.002
Citation: Gao W, Zheng J, Bai JG, Han Z. Effect of surgical timing on postoperative outcomes in patients with acute cholecystitis after delayed percutaneous transhepatic gallbladder drainage. World J Gastrointest Surg 2024; 16(11): 3445-3452