Diagnosis and treatment of 42 cases of acute acalculous cholecystitis

doi:10.3877/cma.j.issn.1674-3946.2021.04.022

Abstract

Abstract:

Objective

To investigate the optimal operation time of acute acalculous cholecystitis (AAC).

Methods

Retrospectively analyze the data of 42 AAC patients undergoing laparoscopic surgery from January 2015 to January 2020. The patients were divided into the<72 h (29 cases) group and >72 h group (13 cases) according to the onset time of AAC. SAS 6.12 statistical software was used to analyze the data. χ² test was used to analyze the intraoperative gallbladder lesions, surgical methods and postoperative complication rate, P<0.05 was considered statistically significant.

Results

Edema and suppuration were the main gallbladder lesions in the<72 h group, the proportion of necrosis and perforation increased in the >72 h group, Laparoscopic subtotal cholecystectomy and cholecystostomy were the main surgical methods. The incidence of postoperative complications such as bleeding, bile leakage, abdominal infection, pulmonary infection and multi-organ failure was higher than that in the <72 h group, with statistical significance (P<0.05).

Conclusion

The operation should be performed within 72 hours after the onset of AAC.

Key words: Acute acalculous cholecystitis, Cholecystectomy, laparoscopic, Necrosis, Postoperative complications, Cholecystostomy

Dezhi Shao, Zhiyi Feng, Naichao Guo, Yanlin Lvy, Xiaocui Wang, Yuhao Dong. Diagnosis and treatment of 42 cases of acute acalculous cholecystitis[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2021, 15(04): 434-436.

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References 20

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组别	例数	年龄(岁)	伴基础病	性别	病史
组别	例数	年龄(岁)	伴基础病	男/女	外伤/手术/无
<72 h组	29	66.6±6.2	24	18/11	5/8/16
>72 h组	13	62.5±7.3	11	7/6	2/4/7
t/χ²值		2.15	1.504	1.611	1.44
P值		0.144	0.210	0.673	0.702

组别	例数	年龄(岁)	伴基础病	性别	病史
组别	例数	年龄(岁)	伴基础病	男/女	外伤/手术/无
<72 h组	29	66.6±6.2	24	18/11	5/8/16
>72 h组	13	62.5±7.3	11	7/6	2/4/7
t/χ²值		2.15	1.504	1.611	1.44
P值		0.144	0.210	0.673	0.702

组别	例	胆囊水肿	胆囊化脓	胆囊坏疽及穿孔
<72 h组	29	7(24.1)	16(55.1)	6(20.7)
>72 h组	13	0(0)	4(30.8)	9(69.2)
χ²值		8.317	5.342	6.331
P值		0.006	0.032	0.027

组别	例	胆囊水肿	胆囊化脓	胆囊坏疽及穿孔
<72 h组	29	7(24.1)	16(55.1)	6(20.7)
>72 h组	13	0(0)	4(30.8)	9(69.2)
χ²值		8.317	5.342	6.331
P值		0.006	0.032	0.027

组别	例	LC	胆囊大部切除术	胆囊造瘘术
<72 h组	29	28(96.5)	1(3.4)	0(0)
>72 h组	13	4(30.8)	6(46.2)	3(23.1)
χ²值		3.361	5.012	4.231
P值		0.031	0.022	0.028

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