Analysis of the Effect of Laparoscopic Cholecystectomy for Acute Cholecystitis after Percutaneous Transhepatic Gallbladder Puncture and Drainage

Abstract

Objective. To assess the effect of laparoscopic cholecystectomy for acute cholecystitis after percutaneous transhepatic gallbladder drainage (PTGBD). Methods. A total of 70 patients with acute cholecystitis diagnosed and treated in our hospital between April 2020 and November 2021 were recruited and assigned to receive either conventional treatment (conventional group) or PTGBD plus laparoscopic cholecystectomy (experimental group) according to the order of admission (with January 2021 as the cut-off time point), with 35 cases in each group. Outcome measures included treatment outcomes, surgical indices, and postoperative recovery. Results. Patients in the experimental group showed significantly less intraoperative hemorrhage volume and shorter operative time, time-lapse before passing gas, and hospital stay (83.15 ± 31.17, 32.54 ± 12.61, 23.02 ± 4.61, 7.98 ± 3.24) versus those in the conventional group (120.56 ± 30.55, 61.01 ± 15.54, 28.15 ± 5.91, 11.95 ± 4.15) ( P < 0.05 ). The incidence of conversion to open surgery and postoperative drainage in the experimental group was significantly lower (2.86%, 5.71%) than that of the conventional group (25.71%, 45.71%) ( P < 0.05 ). The differences in the postoperative body temperature of the two groups did not come up to statistical standard ( P > 0.05 ). The experimental group had faster body temperature recovery and leukocyte recovery and better leukocyte levels (1.25 ± 0.56, 2.36 ± 0.48, 7.92 ± 1.36) than the conventional group (3.11 ± 1.05, 5.41 ± 0.63, 10.52 ± 2.78) ( P < 0.05 ). There was 1 (2.86%) case of pneumothorax and 1 (2.86%) case of intestinal bleeding in the experimental group, and there were 2 (5.71%) cases of biliary leakage, 3 (8.57%) cases of pneumothorax, 4 (11.43%) cases of intestinal bleeding, 5.71% cases of incisional infection, 1 (2.86%) case of respiratory failure, and 1 (2.86%) case of liver damage in the conventional group. The experimental group showed a significantly lower incidence of complications (5.71%) versus the conventional group (37.14%) ( P < 0.05 ). Conclusion. PTGBD plus laparoscopic cholecystectomy for acute cholecystitis effectively improves surgical safety, promotes patients' postoperative recovery, and reduces the incidence of conversion to open surgery and postoperative complications with a high safety profile. Further trials are, however, required prior to clinical promotion.

Outcome of laparoscopic cholecystectomy with and without drains at Ayub Teaching Hospital

“…In addition, 55.5% of our study participants had a body mass index (BMI) of 25 or higher. Accordingly, our findings indirectly support the adage that Cholelithiasis is more common among women over the age of 40 who are fertile and overweight [8][9][10]. When compared to other studies, including one that found an overall infection rate of 3.6%, our study's 12.2% risk of post-operative wound infection was extremely high.…”

Evaluating effectiveness and safety of combined percutaneous transhepatic gallbladder drainage and laparoscopic cholecystectomy in acute cholecystitis patients: Meta-analysis

“…Operative time: In this comprehensive analysis, all 24 studies[ 9 - 32 ] included a comparative assessment of operative times across the two groups. The heterogeneity test indicated a highly significant variance ( P < 0.00001, I² = 94%), thus indicating the application of a random-effects model for the analysis.…”

“…Conversion to open surgery rate: Twenty-two studies[ 9 , 10 , 12 - 28 , 30 - 32 ] compared the rate of conversion to open surgery between the two groups. The heterogeneity test results showed P = 0.005 and I² = 50%, indicating significant heterogeneity.…”

“…Intraoperative blood loss: Seventeen studies[ 9 - 16 , 18 , 19 , 22 , 26 - 28 , 30 - 32 ] compared intraoperative blood loss between the two groups. The heterogeneity test results showed P < 0.00001 and I² = 97%, necessitating the use of a random-effects model for the analysis.…”

Retracted: Analysis of the Effect of Laparoscopic Cholecystectomy for Acute Cholecystitis after Percutaneous Transhepatic Gallbladder Puncture and Drainage

“…This article has been retracted by Hindawi, as publisher, following an investigation undertaken by the publisher [ 1 ]. This investigation has uncovered evidence of systematic manipulation of the publication and peer-review process.…”