To explore the optimal timing for elective laparoscopic cholecystectomy (LC) after percutaneous transhepatic gallbladder drainage (PTGD) in patients with high-risk acute suppurative cholecystitis (ASC).

A retrospective study was conducted on 206 patients with high-risk ASC who were treated in our hospital from September 2016 to March 2022. According to the interval between PTGD and LC (PTGD-LC interval), the patients were divided into the early LC group (4 weeks≤PTGD-LC interval<6 weeks, n=96 cases) and the late LC group (6 weeks≤PTGD-LC interval<8 weeks, n=110 cases). Statistical software SPSS 21.0 was used for data analysis. The 36-Item Short Form Health Survey (SF-36) scores (before and after surgery), operation time, blood loss, postoperative time to first flatus, postoperative time to oral intake, drainage tube removal time, and length of hospital stay in the two groups were expressed as (±s) and analyzed by t test. The rates of partial cholecystectomy, severe pericholecystic adhesion, conversion to open surgery, postoperative complication rate, and pain scores were compared between the two groups using the χ² test. A P-value<0.05 was considered statistically significant.

The operation time, postoperative time to first flatus, postoperative time to oral intake, drainage tube removal time, and length of hospital stay in the early LC group were longer than those in the late LC group (all P<0.05). The intraoperative blood loss, conversion rate to open surgery, and rate of severe pericholecystic adhesion in the early LC group were higher than those in the late LC group (all P<0.05). The SF-36 score in the early LC group was worse than that in the late LC group, with a statistically significant difference (P<0.05). There were no significant differences in the rate of partial cholecystectomy, postoperative complication rate, or postoperative pain score between the two groups (all P>0.05).

Performing LC 6–8 weeks after PTGD can shorten the operation time and length of hospital stay, and is conducive to improving the quality of life of patients with high-risk ASC.