PTGBD序贯LC与一期LC治疗中度急性胆囊炎效果的倾向性评分匹配分析OACSTPCD

Objective To explore the clinical outcomes of percutaneous transhepatic gallbladder drainage(PTGBD)followed by laparoscopic cholecystectomy(LC)for the treatment of moderate acute cholecystitis.Methods The clinical data of 178 patients with moderate acute cholecystitis admitted to the General Hospital of Pingmeishenma Medical Group from Aug.2020 to Aug.2022 were retrospectively analyzed.The patients were divided into two groups based on the surgical methods:one-stage LC group(n=133)and PTGBD followed by LC group(n=45).Propensity score matching analysis(PSM)was used to match the two groups in a 1:1 ratio.Baseline data of patients before and after PSM were compared,and various indicators of patients in the two groups after PSM were also compared.Results All 45 patients in PTGBD followed by LC group successfully completed the operation without experiencing bleeding or bile leakage.The age and gallbladder wall thickness of patients in PTGBD followed by LC group before PSM were higher than those in one-stage LC group(P<0.05).After PSM,there were 40 patients in each group,and the baseline data of the two groups were similar(P>0.05).Post-PSM analysis revealed that the PTGBD followed by LC group had significantly shorter operation time and postoperative hospital stay,less intraoperative blood loss,lower incidence of severe complications,and higher hospitalization costs compared to the one-stage LC group(all P<0.05).Conclusion PTGBD followed by LC demonstrates efficacy in treating patients with moderate acute cholecystitis by decreasing operation time,minimizing intraoperative blood loss,and lowering the risk of postoperative complications while maintaining a high level of safety.However,the complications such as needle bleeding may occur and increase the economic burden.Despite these drawbacks,the benefits of this approach outweigh the disadvantages,making it a promising technique worthy of further implementation and exploration.