2016 Volume 30 Issue 4 Pages 667-672
Methods: The 63 patients with acute cholecystitis who underwent laparoscopic cholecystectomy (LC) after PTGBD were retrospectively examined for the evaluation of the operative difficulty for a safety operation.
Results: An intraoperative blood loss and a rate of conversion to open surgery were high in the cases more than 20mg/dl of CRP and needed a long term for the reduction of the CRP level, more than 30cm/s of the Vmax level in doppler ultrasonography, thickness, of gallbladder wall over 5cm on CT scan before PTGBD, no cystic duct patency in the PTGBD cholangiogram, more than 24 hours of the time interval from the onset to PTGBD, more than 14 days of the interval from PTGBD to operation.
Conclusions: The preoperative serum CRP level, the Vmax level, thickness, of gallbladder wall on CT scan before PTGBD and the obstruction of the cystic duct on PTGBD cholangiogram and the time interval from the onset to PTGBD were useful for the evaluation of the operative difficulty. It was considered that PTGBD within 24 hours after onset followed by operation for more than 14 days after PTGBD was contribute to reduction in intraoperative bleeding.
