In:
Journal of Hepato-Biliary-Pancreatic Sciences, Wiley, Vol. 28, No. 6 ( 2021-06), p. 515-523
Abstract:
Laparoscopic cholecystectomy (Lap‐C) is generally performed following percutaneous transhepatic gallbladder drainage (PTGBD) in patients with acute cholecystitis (AC). However, the timing of Lap‐C and risk factors for postoperative complications following PTGBD are still unclear. Methods We analyzed 331 patients with AC who underwent Lap‐C following PTGBD. Univariate and multivariate logistic regression analyses were used for identifying risk factors associated with poor surgical outcomes, including postoperative complications in the total group and the early Lap‐C subgroup (n = 152). Based on the Tokyo guideline 2013 (TG 13), all patients were divided into two groups according to the period (2009–2013, pre‐TG 13 group; 2014–2020, post‐TG 13 group), and each analysis was performed in those subgroups. Results We found that early Lap‐C (≤ 42 days after PTGBD) was associated with postoperative complications (OR 2.04, P = .022). Importantly, subgroup analyses revealed that Charlson comorbidity index (CCI) (OR 6.15, P 〈 .001) and cholecystitis severity grade (OR 2.93, P = .014) were independent risk factors of postoperative complications in the early Lap‐C group. Among the early Lap‐C group, high CCI was also an independent risk factor for surgical complications in both pre‐TG 13 (OR 14.87, P = .003) and post‐TG 13 (OR 3.23, P = .046) groups. Interestingly, we found that the incidence of postoperative complications in the low‐risk early Lap‐C group was not different from the delayed group, even in the cases of very early surgery (≤ 1 week following PTGBD). Conclusions These findings suggest that early Lap‐C is feasible following PTGBD, especially in low‐risk patients, although future prospective large‐scale studies are needed.
Type of Medium:
Online Resource
ISSN:
1868-6974
,
1868-6982
Language:
English
Publisher:
Wiley
Publication Date:
2021
detail.hit.zdb_id:
2536390-6
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