Application of percutaneous transhepatic gallbladder drainage combined with laparoscopic cholecystectomy sequential treatment in patients with delayed acute suppurative cholecystitis surgery

XIE Bowen; ZHONG Caihong; LIU Youyuan; WU Haoran; YIN Mingxiang

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Journal of Hunan Normal University(Medical Science) ›› 2025, Vol. 22 ›› Issue (4) : 156-159.

Application of percutaneous transhepatic gallbladder drainage combined with laparoscopic cholecystectomy sequential treatment in patients with delayed acute suppurative cholecystitis surgery

XIE Bowen¹, ZHONG Caihong¹, LIU Youyuan², WU Haoran², YIN Mingxiang²

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Abstract

Objective To explore the application value of sequential treatment of percutaneous transhepatic gallbladder drainage (PTGBD) combined with laparoscopic cholecystectomy (LC) in patients with acute suppurative cholecystitis. Method 140 patients with acute suppurative cholecystitis who had onset time of more than 72 hours in Loudi Central Hospital and Changde Hospital affiliated to Xiangya Medical College of Central South University from January 2020 to January 2024 were collected as the research subjects. They were divided into the study group (70 cases in the sequential treatment group) and the control group (70 cases in the simple LC group) according to the different treatment plans received. The changes in various indicators and the incidence of complications during and after surgery were compared between the two groups. Results The average operation time, intraoperative blood loss, and total postoperative hospitalization time in the study group were all less than those in the control group. The first postoperative exhaust time and postoperative ambulation time in the study group were both earlier than those in the control group. The first laboratory scores of white blood cells, C-reactive protein, and serum IL-6 in the study group patients after surgery were statistically significant. The incidence of postoperative complications in the two groups of patients was as follows: 3 cases of hepatic insufficiency and 2 cases of fever in the study group, and 12 cases of hepatic insufficiency, 2 cases of postoperative biliary fistula, 1 case of bleeding, 10 cases of fever, 3 cases of conversion to open surgery, and 2 cases of biliary tract injury (1 case of right posterior lobe bile duct injury and 1 case of common hepatic duct injury) in the control group. There was a statistically significant difference in the overall incidence of complications. Conclusion PTGBD combined with LC sequential treatment can reduce the occurrence of complications, shorten the operation time, alleviate postoperative inflammatory reactions, and help patients recover quickly after surgery in patients with acute suppurative cholecystitis.

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acute suppurative cholecystitis / gallbladder puncture / rapid rehabilitation

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XIE Bowen, ZHONG Caihong, LIU Youyuan, WU Haoran, YIN Mingxiang. Application of percutaneous transhepatic gallbladder drainage combined with laparoscopic cholecystectomy sequential treatment in patients with delayed acute suppurative cholecystitis surgery[J]. Journal of Hunan Normal University(Medical Science). 2025, 22(4): 156-159

References

[1] 李征, 郑亚民. 急性胆囊炎东京指南与欧洲世界急诊外科协会指南的比较[J]. 中华肝胆外科杂志, 2021, 27(11): 875-880.
[2] 付军, 齐敦峰, 王振, 等. PTGBD治疗TG18中重度急性胆囊炎123例临床疗效分析[J]. 肝胆外科杂志, 2024, 32(1): 26-28.
[3] 何飞, 周明, 管思强. 急性胆囊炎腹腔镜胆囊切除术后并发症危险因素与风险预测模型的构建[J]. 中国现代普通外科进展, 2024, 27(9): 709-713.
[4] 李小平, 晏江, 姚国忠, 等. 急性结石嵌顿性胆囊炎发病72小时内行腹腔镜手术80例分析[J]. 江苏医药, 2019, 45(8): 773-775.
[5] 伍万权. 腹腔镜胆囊切除术胆道损伤相关因素分析及预防[J]. 中华肝脏外科手术学电子杂志, 2023, 8(6): 538-541.
[6] 吴硕东. 基于损伤控制理念的胆道疾病处理与治疗[J]. 外科理论与实践, 2023, 28(2): 115-118.
[7] 中华医学会外科学分会胆道外科学组. 急性胆道系统感染的诊断和治疗指南 (2021版)[J]. 中华外科杂志, 2021, 59(6): 422-429.
[8] 高振山, 陈鹃, 于华. 腹腔镜胆囊切除和传统开放手术治疗急性化脓性胆囊炎的临床效果比较[J]. 南通大学学报 (医学版), 2023, 43(5): 484-486.
[9] 巫泓生, 马克强, 嵇腾飞, 等. 急性胆囊炎早期与延迟腹腔镜手术对比的Meta分析[J]. 腹腔镜外科杂志, 2022, 27(7): 527-534.
[10] 王浩龙, 李增辉, 何万民, 等. 早期腹腔镜胆囊切除术在急性胆囊炎中的应用研究[J]. 中国临床医生杂志, 2020, 48(6): 715-717.
[11] 黄倩倩, 王亚栋, 徐倩倩, 等. 腹腔镜胆囊大部切除胆囊管旷置术在急性化脓性胆囊炎中的应用[J]. 腹腔镜外科杂志, 2021, 26(8): 627-629.
[12] 章伟, 张文俊. 经皮穿肝胆道引流序贯腹腔镜胆囊切除术治疗高龄急性化脓性胆囊炎临床观察[J]. 解放军医药杂志, 2022, 34(9): 47-49, 59.
[13] 秦强, 孙世波, 陈望, 等. 腹腔镜复杂胆囊切除术中预防医源性胆道损伤的临床体会[J]. 腹腔镜外科杂志, 2022, 27(5): 358-361.
[14] 程国凌, 徐化楠, 刘义宾. 急性胆囊炎患者经皮经肝穿刺胆囊引流术后序贯腹腔镜胆囊切除术的最佳手术时机[J]. 河南医学研究, 2024, 33(1): 57-60.
[15] OKADA Y, KAWAGUCHI Y, MATSUMURA M, et al.A safe sequential treatment approach for patients who have acute cholecystitis with severe inflammation: Transmural gallbladder drainage followed by laparoscopic cholecystectomy under the guidance of fluorescence imaging[J]. Asian J Endosc Surg, 2022, 15(1): 230-234.
[16] 蒋保华, 金磊, 俞晓峰, 等. CT引导下经皮经肝胆囊穿刺引流术在高危急性胆囊炎治疗中的价值[J]. 实用放射学杂志, 2024, 40(2): 289-292.
[17] JUNG WH, PARK DE.Timing of Cholecystectomy after Percutaneous Cholecystostomy for Acute Cholecystitis[J]. Korean J Gastroenterol, 2025, 66(4): 209-214.
[18] 姜飞, 李霞, 孔祥崇, 等. 超声引导下PTGBD联合LC治疗中度急性胆囊炎的疗效观察[J]. 腹部外科, 2025, 38(3): 219-223, 228.
[19] 惠文静, 许海英, 王赖儿. 早期急性胆囊炎行PTGBD联合LC序贯治疗的回顾性队列研究[J]. 海南医学, 2023, 34(7): 957-960.
[20] 吕蒙, 苏伟, 赵锐, 等. PTGBD术后早期行LC治疗发病时间>72 h的胆囊结石伴急性胆囊炎的疗效分析[J]. 中国现代普通外科进展, 2024, 27(8): 639-641.
[21] EL-GENDI A, EL-SHAFEI M, EMARA D.Emergency Versus Delayed Cholecystectomy After Percutaneous Transhepatic Gallbladder Drainage in Grade II Acute Cholecystitis Patients[J]. J Gastrointest Surg, 2017, 21(2): 284-293.
[22] BAO J, WANG J, SHANG H, et al.The choice of operation timing of laparoscopic cholecystectomy (LC) after percutaneous transhepatic gallbladder drainage (PTGBD) for acute cholecystitis: a retrospective clinical analysis.[J]. Ann Palliat Med, 2021, 10(8): 9096-9104.