Efficacy of early laparoscopic cholecystectomy compared with percutaneous transhepatic gallbladder drainage in treating acute calculous cholecystitis in elderly patients

Abstract

Background

Acute calculous cholecystitis is a common acute disease in elderly patients. This study aimed to evaluate the efficacy of early laparoscopic cholecystectomy (ELC) compared to percutaneous transhepatic gallbladder drainage (PTGD) for treating acute calculous cholecystitis in elderly patients.

Methods

This retrospective study compared the clinical outcomes of two groups of elderly patients treated with ELC (group A) and PTGD (group B) from January 2018 to December 2021. Preoperative clinical characteristics and postoperative treatment outcomes were analyzed for both groups.

Results

There were no statistically significant differences in preoperative clinical characteristics between the ELC and PTGD groups. ELC took longer to perform (69.8 ± 15.9 min vs. 29.6 ± 5.3 min, p < 0.001) but resulted in a significantly shorter duration of pain (1.9 ± 0.9 days vs. 3.9 ± 1.0 days, p < 0.001) and hospital stay (6.3 ± 2.5 days vs. 9.9 ± 3.6 days, p < 0.001), and a lower rate of sepsis (3.4% vs. 16.9%, p < 0.019). Time to soft diet was faster in the ELC group (1.5 ± 0.9 days vs. 3.0 ± 1.6 days, p < 0.001). Fewer patients in the ELC group experienced surgical reintervention than in the PTGD group (0% vs. 5.6%, p = 0.043). The incidence of postoperative complications and readmission rates in the ELC group were significantly lower than those in the PTGD group (ELC, 3.6%; PTGD, 25.4%, p = 0.001).

Conclusions

ELC is an effective treatment option for acute calculous cholecystitis in elderly patients, and has the added benefits of low postoperative complication rates, rapid recovery, shorter duration of pain, and excellent curative effects as compared to PTGD.

Keywords:

• Elderly
• acute calculous cholecystitis (ACC)
• Early laparoscopic cholecystectomy (ELC)
• percutaneous transhepatic gallbladder drainage (PTGD)

Authors’ contributions

Tianchong Wu, Wenhao Huang and Haisong Xu have given substantial contributions to the conception and the design of the manuscript, Mingyue Li to provision of study materials or patients, Yuehua Guo, and Gongze Peng to collection and assembly of data, Wenhao Huang and Haisong Xu to data analysis and interpretation.

All authors have participated to drafting the manuscript, author A revised it critically. All authors read and approved the final version of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

The authors certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript.

Additional information

Funding

This work was supported by the Science and Technology Innovation Foundation of Shenzhen (Nos. JCYJ20180228164603659 and JCYJ20220530152200001), Shenzhen Key Medical Discipline Construction Fund(No.SZXK015, Guangdong Provincial Key Clinical Specialty Construction Project and National Key Clinical Specialty Construction Project, the Clinical Research and cultivation project of Shenzhen People’s Hospital (No.SYLCYJ202003).