Elective Cholecystectomy After Endoscopic Gallbladder Stenting for Acute Cholecystitis: A Propensity Score Matching Analysis.

IF 1.1 4区医学 Q3 SURGERY

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques Pub Date : 2024-04-01 DOI:10.1097/SLE.0000000000001252

Shinjiro Kobayashi, Kazunari Nakahara, Saori Umezawa, Keisuke Ida, Atsuhito Tsuchihashi, Satoshi Koizumi, Junya Sato, Keisuke Tateishi, Takehito Otsubo

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引用次数: 0

Abstract

Objective: To investigate the influence of endoscopic gallbladder stenting (EGBS) on subsequent cholecystectomy. We retrospectively compared the surgical outcomes of EGBS, followed by elective cholecystectomy with those of immediate cholecystectomy (IC).

Patients and methods: A total of 503 patients were included in this study. Patients who underwent EGBS as initial treatment for acute cholecystitis, followed by elective cholecystectomy, were included in the EGBS group and patients who underwent IC during hospitalization were included in the IC group. Propensity score matching analysis was used to compare the surgical outcomes. In addition, the factors that increased the amount of bleeding were examined by multivariate analysis after matching.

Results: Fifty-seven matched pairs were obtained after propensity matching the EGBS group and the IC group. The rate of laparoscopic cholecystectomy in the EGBS versus IC groups was 91.2% versus 49.1% ( P < 0.001). The amount of bleeding was 5 mL in the EGBS versus 188 mL in the IC group ( P < 0.001). In the EGBS and IC groups, multivariate analysis of factors associated with more blood loss revealed IC (odds ratio: 4.76, 95% CI: 1.25-20.76, P = 0.022) as an independent risk factor.

Conclusion: EGBS as the initial treatment for acute cholecystitis and subsequent elective cholecystectomy after the inflammation has disappeared can be performed in minimally invasive procedures and safely.

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急性胆囊炎内镜胆囊支架置入术后的选择性胆囊切除术：倾向评分匹配分析

目的研究内镜胆囊支架植入术（EGBS）对后续胆囊切除术的影响。我们回顾性比较了 EGBS 和即刻胆囊切除术（IC）的手术效果：本研究共纳入 503 名患者。EGBS组包括接受EGBS作为急性胆囊炎初始治疗并随后接受择期胆囊切除术的患者，IC组包括在住院期间接受IC治疗的患者。采用倾向评分匹配分析比较手术结果。此外，配对后还通过多变量分析研究了增加出血量的因素：结果：在对 EGBS 组和 IC 组进行倾向性匹配后，获得了 57 对匹配对。EGBS 组和 IC 组的腹腔镜胆囊切除术率分别为 91.2% 和 49.1%（P < 0.001）。EGBS 组的出血量为 5 毫升，而 IC 组为 188 毫升（P < 0.001）。在 EGBS 组和 IC 组中，对失血较多的相关因素进行的多变量分析显示，IC（几率比：4.76，95% CI：1.25-20.76，P = 0.022）是一个独立的风险因素：结论：将 EGBS 作为急性胆囊炎的初始治疗方法，并在炎症消失后进行择期胆囊切除术，可以在微创手术中安全进行。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques 医学-外科

CiteScore

2.00

自引率

10.00%

发文量

103

审稿时长

3-8 weeks

期刊介绍： Surgical Laparoscopy Endoscopy & Percutaneous Techniques is a primary source for peer-reviewed, original articles on the newest techniques and applications in operative laparoscopy and endoscopy. Its Editorial Board includes many of the surgeons who pioneered the use of these revolutionary techniques. The journal provides complete, timely, accurate, practical coverage of laparoscopic and endoscopic techniques and procedures; current clinical and basic science research; preoperative and postoperative patient management; complications in laparoscopic and endoscopic surgery; and new developments in instrumentation and technology.