Abstract
Introduction: Percutaneous transhepatic gallbladder drainage (PTGBD) is a safe, effective initial treatment for acute cholecystitis in high-risk patients. Laparoscopic cholecystectomy (LC) is the definitive treatment. This study evaluates the feasibility and optimal timing of LC post-PTGBD at Le Van Thinh Hospital, as outcomes may be similar regardless of surgical timing.
Patients and Methods: A prospective descriptive case series was conducted from January 2022 to June 2024 at the General Surgery Department of Le Van Thinh Hospital. Patients diagnosed with grade II, III acute calculous cholecystitis who underwent PTGBD followed by LC were included. Patients were categorized into two groups based on the timing of surgery: within (group A) or beyond four weeks (Group B) post-PTGBD.
Results: Seventeen patients underwent LC after PTGBD (mean age 68.76 ± 17.70 years; 41.2% male). Mean operative time was 114 ± 28.51 minutes with no conversions to open surgery. Intraoperative and postoperative complications occurred in 11.8% and 23.5% of patients, respectively. The mean hospital stay was 7 ± 1.83 days. Patients in Group A were generally younger and had fewer comorbidities and lower ASA scores compared to those in Group B. Although overall surgical outcomes were comparable, intraoperative complications were more frequent in Group B.
Conclusions: LC following PTGBD for acute calculous cholecystitis is a safe and effective procedure, with low complication rates in appropriately selected patients with well-managed infections and comorbid conditions.
Keywords: Acute calculous cholecystitis, percutaneous transhepatic gallbladder drainage, laparoscopic cholecystectomy.
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