Study of clinical prognosis in the choice of operation time for calculus incarcerated cholecystitis patients / 国际外科学杂志

ABSTRACT

Objective To explore the difference between the curative effect and the prognosis under different time of surgery for calculus incarcerated cholecystitis patients.Methods Ninty-three cases of acute cholecystitis caused by stone inlay in the neck of the gallbladder patients in Xiaogan First People's Hospital from April 2013 to April 2015 were divided into group A and group B according to the duration.Group Athe course of disease was within 72 hours(n =43).Group Bthe course of disease was over 72 hours (n =50).The observation indicators of the two groups included (1)operation conditionoperation time,postoperative anal exhaust time,postoperative pain time,intraoperative blood loss and length of hospital stay;(2) conversion to laparotomy situation;(3) the postoperative complications of pulmonary infection,abdominal infection,incision infection,bile leakage.All the patients were followed up by outpatient or telephone,inquiried and recorded patient's health status.The deadline for follow-up was October 2015.The measurement data were expressed by ((x) ± s) and comparison between groups was analyzed by using t test.Count data were analyzed using x2 test.Results (1) The average operation time,postoperative anal exhaust time,postoperative pain time,intraoperative blood loss and hospitalization time of group Awere (56.4±12.7) minutes,(37.8±4.6) hours,(24.2±3.8) hours,(58.3± 14.3) ml,(4.8± 2.9) days respectively,the data of group B were (82.5 ± 15.8) minutes,(76.2 ±7.8) hours,(53.8 ± 7.8) hours,(71.4 ± 16.9) ml,(7.8 ± 2.5) days respectively,the difference between the two groups were statistically significant (all P ＜ 0.05);(2) The conversion rate of laparotomy in group A (4.65％,2/43) was significantly less than group B (18.00％,9/50),and the difference was statistically significant (P ＜ 0.05);(3)The complication rate in group A (4.65％,2/43) was significantly less than group B (16.00％,8/50),and the difference was statistically significant (P ＜ 0.05).Conclusion The prognosis of calculous incarcerated cholecystitis with different surgical time is significantly different,the prognosis of the patients duration within 72 hours surgery prognosis was significantly better than the duration more than 72 hours surgery.