[Clinical and economic aspects of laparoscopic surgery for acute cholecystitis in delayed presentation]. / Kliniko-ekonomicheskie aspekty laparoskopicheskikh operatsii pri ostrom kholetsistite v usloviyakh pozdnei gospitalizatsii.
Khirurgiia (Mosk)
; (12): 7-13, 2023.
Article
in Ru
| MEDLINE
| ID: mdl-38088836
ABSTRACT
OBJECTIVE:
To study the clinical and economic features of laparoscopic surgery for acute cholecystitis in delayed presentation. MATERIAL ANDMETHODS:
A prospective non-randomized study (2020-2021) included 101 patients (73.2% (n=74) men and 26.8% (n=27) women, mean age 58±14.9 years) with acute cholecystitis who underwent laparoscopic cholecystectomy. Cost-effectiveness analysis of laparoscopic cholecystectomy at various periods after clinical manifestation was performed.RESULTS:
Surgical treatment within 72 hours was performed in 15% (n=16) of cases (group 1), within 4-10 days - in 57.5% (n=58) (group 2), after 10 days - in 26.7% (n=27) of patients (group 3). Overall incidence of postoperative complications was 2.9%, postoperative mortality - 1.9% (two patients died from widespread peritonitis). Surgery time was 70 [65-83], 85 [69-110] and 115 [80-125] min (H=15.55, p<0.001), hospital-stay - 6 [5-7], 9 [7-10] and 11 [7-14] days, respectively (H=21.86, p<0.001). Cost of direct (medical and non-medical) treatment amounted to 29484 [27 509-33 885], 41265 [34 306-48 301] and 50591 [37 069-62 483] rubles, respectively (H=29.71, p<0.001)).CONCLUSION:
Delayed hospitalization and surgical treatment of acute cholecystitis after 72 hours are accompanied by higher treatment costs by 29% in the period up to 10 days and by 58% after 10 days. These results require further validation and adjustment in large samples.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Cholecystectomy, Laparoscopic
/
Laparoscopy
/
Cholecystitis, Acute
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
Ru
Journal:
Khirurgiia (Mosk)
Year:
2023
Document type:
Article
Affiliation country:
RUSSIA