Is the presence of a catheter and time of surgery effective in conversion to open surgery in interval cholecystectomies after percutaneous drainage in acute cholecystitis?

在急性胆囊炎经皮引流后行间隔性胆囊切除术时,导管的存在和手术时间是否能有效降低转为开腹手术的风险?

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Abstract

OBJECTIVE: There are no guidelines regarding intraoperative or preoperative catheter removal in patients eligible for surgery following percutaneous drainage in acute cholecystitis. In this study, we evaluated the factors affecting the conversion to open surgery after percutaneous drainage and analyzed the relationship between catheter presence and time to operation in interval laparoscopic cholecystectomy. METHODS: In total, 50 patients with acute cholecystitis who underwent interval laparoscopic cholecystectomy after percutaneous drainage were retrospectively evaluated and grouped according to conversion to open surgery (Group 1) and non (Group 2). Factors that may be associated with conversion to open surgery and the presence of an intraoperative catheter were evaluated, and the time to surgery was calculated. RESULTS: There were 28 (56%) men and 22 (44%) women, and the mean age was 64 (±13) years. The severity of acute cholecystitis was moderate in 37 (74%) patients and severe in 13 (26%). When the groups were compared, no statistically significant difference was found between the presence of a catheter, the time of surgery 8 weeks before and after, and the conversion to open surgery. Postoperative hospitalization days were significantly higher in Group 1 (p=0.014). CONCLUSION: In patients who underwent interval laparoscopic cholecystectomy after insertion of a percutaneous drainage catheter in acute cholecystitis, the presence of a catheter and the waiting time for surgery after catheter insertion do not affect the rates of conversion to open surgery and complications.

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