title: Comparison of clinical result between early laparoscopic cholecystectomy and delayed laparoscopic cholecystectomy after percutaneous transhepatic gallbladder drainage for patients with complicated acute cholecystitis.
abstract: OBJECTIVE
  In the treatment of complicated cholecystitis, laparoscopic cholecystectomy (LC) has limited efficacy due to its substantial post-operative complications. In addition, the clinical characteristics of complicated cholecystitis (CC) patients were suspected as advanced age with highly risky comorbidity. Percutaneous transhepatic gall bladder (PTGBD) drainage could be an alternative option for successful LC. Hence, this study evaluated the outcome of PTGBD for CC within and after 5 days.
  
  
  METHODS
  The medical records of 109 consecutive CC patients who had undergone an LC between January 2007 and December 2011 were retrospectively reviewed and compared with the medical records of CC patients who had undergone an LC within 72 hours of (group I, n=63) or 5 days after PTGBD (group II, n=40). In addition, group I was divided into group Ia (n=46) and group Ib (n=17), according to the patients' development of open-conversion or post-operative complications. The clinical outcomes of the four groups were analyzed.
  
  
  RESULTS
  There was a significantly higher reference to age, the ASA score grading, and predominant comorbidities in group II than in group I. The peri-operative results of group II showed lower blood loss and relatively shorter operating times than those of group I. In the cases of early LC within 72 hours (group Ia vs. group Ib), the difference was statistically insignificant.
  
  
  CONCLUSIONS
  The delayed LC after PTGBD for complicated cholecystitis with high clinical risk had better results in this study, although it prolonged the patient's hospital stay.
authors.affiliation: Department of Surgery, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea.
authors.forename: Jae Woo
authors.initials: JW
authors.lastname: Choi
authors.affiliation: Department of Surgery, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea.
authors.forename: Sin Hui
authors.initials: SH
authors.lastname: Park
authors.affiliation: Department of Surgery, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea.
authors.forename: Sang Yong
authors.initials: SY
authors.lastname: Choi
authors.affiliation: Department of Surgery, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea.
authors.forename: Haeng Soo
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Department of Surgery, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea.
authors.forename: Taeg Hyun
authors.initials: TH
authors.lastname: Kim
keywords: Complicated cholecystitis; Delayed laparoscopic cholecystectomy; Early laparoscopic cholecystectomy; Percutaneous transhepatic gallbladder drainage