Optimal timing of laparoscopic cholecystectomy after percutaneous gallbladder drainage in patients with acute calculous cholecystitis: A retrospective comparative study
Year: 2025
Type: article
Study design: Observational Study
Abstract: Backgrounds/Aims: Laparoscopic cholecystectomy (LC) is the standard therapy for acute calculous cholecystitis (ACC). However, high-risk patients often require percutaneous gallbladder drainage (PGBD) as a bridge to surgery. The optimal interval between PGBD and LC remains uncertain. Methods: We retrospectively reviewed 177 patients who underwent LC after PGBD for ACC at Nhan dan Gia Dinh Hospital (2018-2024). Patients were stratified by drainage-to-surgery interval: Q1, ≤ 9 days; Q2, 10-17 days; Q3, 18-32 days; Q4, ≥ 32 days. Primary outcomes were operative time, conversion, intraoperative bleeding, postoperative stay, and Clavien-Dindo complications. Multivariable logistic regression was performed after adjusting for age, Charlson Comorbidity Index (CCI), TG18 severity, sex, prior endoscopic retrograde cholangiopancreatography, and Concurrent PGBD and LC during the same admission. Results: = 0.019), being the highest in Q4 (68.2%) and the lowest in Q2 (36.4%). Q3 showed the shortest operative time (median: 90 min) and the lowest complication rate (11.4%). In adjusted analysis, only CCI independently predicted bleeding (adjusted odds ratio: 1.42; 95% confidence interval: 1.02-2.03), while timing lost its statistical significance. Conclusions: Scheduling LC 18-32 days after PGBD offers the most balanced surgical profile, whereas delaying beyond 32 days increases bleeding without added benefit. Comorbidity burden rather than calendar interval per se appears to increase bleeding risk. Prospective studies are warranted to confirm the intermediate 2- to 4-week window.
Authors: Kim-Long Le, Tien-Quang Pham, Phu-Cuong Pham, Minh-Quang Tran, Tri-Nhan Pham, My-Tran Trinh, Nguyen-Khoi Le, Hai Van Nguyen
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4411360540