경희대학교
의과대학 외과학교실
최성일·이상목·고영관·고석환·홍성화·주홍재
Early
Versus Delayed Laparoscopic Cbolecystectomy in Acute Cholecystitis
Sung
IL Choi, M.D., Sang Mok Lee, M.D., Young Gwan Ko, M.D
Suck
Hwan Koh, M.D., Sung Wha Hong, M D. and Hoong Zae Joo M.D.
Department
of Surgery, Kyung Hee University Hospital
Purpose:
The laparoscopic cholecystectomy has increasingly, been accepted as the procedure
of choice for treatment of symptomatic gall stones and chronic cholecystitis. However,
its role and its timing in the management of patients with acute cholecystitis remain
controversial. This retrospective study was undertaken to compare on early laparoscopic
cholecystectomy with a delay one for patients with acute cholecystitis.
Methods:
Between January 1995 and June 1999, 15 patients were operated on within 72 hours
of symptom onset. Those patients were classified as the early laparoscopic cholecystectomy
group. The 18 patients who underwent a delayed laparoscopic cholecystectomy after
a percutaneous transhepatic cholecystostomy(PTCS) and conservative management were
classified as the delayed laparoscopic cholecystectomy group.
Results:
No significant differences were seen in the conversion rate (1 case in the delayed
group), the operation time (early group l07.3 min., delayed group 118.6 min.), postoperative
complications (early group 20.0%, delayed group l6.7%), and the postoperative hospital
stay (early group 4.7 days, delayed group 7.l days). The early group had significantly
more frequent operation modifications and decreased total hospital stays than the
delayed group: 86.7% and 7,0 days, for the early group and 44.4% and 22.8 days for
the delayed group).
Conclusion:
Early laparoscopic cholecystectomy for acute cholecystitis did not increase the
operation time, the morbidity, of the conversion rate. Although this study was not
a randomized study and the sample size was small, ar early laparoscopic cholecystectomy
seems to be safe and feasible for patients with acute cholecystitis, having the
benefit of a decreased total hospital stay.
Key
Words: Laparoscopic cholecystectomy, Acute cholecystitis
중심단어
: 복강경 담낭 절제술, 급성담낭염 |
