Percutaneous Gallbladder Drainage and Optimal Timing for Successful Laparoscopic Cholecystectomy in Acute Complicated Cholecystitis

ABSTRACT

PURPOSE: Laparoscopic cholecystectomy (LC) has been standard in the treatment of uncomplicated symptomatic gallstone disease, but it has been limited for the management of more complicated cholecystitis because of technical difficulties, high conversion rate and postoperative complication rate. Percutaneous gallbladder drainage (PGBD) could been a feasible option for successful LC in patients with acute complicated cholecystitis. Optimal timing of successful LC in acute complicated cholecystitis have been controversy. Aim of this study is to evaluate clinical usefulness of PGBD and optimal timing of successful LC for acute complicated cholecystitis, which is to determine whether PGBD can reduce the conversion or complication rate and shorten the operative time or postoperative hospital stay and timing of LC. METHODS: We retrospectively reviewed the medical records of total 230 patients underwent LC for acute cholecystitis during Jan.1994-March 2005 at DongKang hospital. We divided 2 groups patients into complicated cholecystitis and cholecystitis, Which were subdivided each into PGBD and non-PGBD group by whether PGBD performed and PGBD subdivided into the early LC. RESULTS: Summarized results described above firstly non- PGBD complicated cholecystitis showed higher conversion rate and postoperative complication rate and longer OP. time compared to PGBD group, secondly following PGBD, delayed LC have advantages of lower conversion rate and complication rate and shorter OP. time compared to early LC group. CONCLUSION: PGBD for LC is safe and effective method to immediate LC in the management of acute complicated cholecystitis. Delayed LC after PGBD would be best option of management for acute complicated cholecystitis.