Runze Xu1, Yefang Xu2, Ran Xu2. 1. Graduate School, School of Medicine, Shanghai Jiaotong University Shanghai City, China. 2. The Center for The Diagnosis and Treatment of Tumor, Rudong Hospital Affiliated to Nantong University Nantong, Jiangsu Province, China.
Abstract
OBJECTIVE: To discuss the effect of the timing of laparoscopic cholecystectomy (LC) on postoperative efficacy and rehabilitation in elderly patients with acute cholecystitis (AC). METHODS: Ninety-four elderly patients with AC were retrospectively selected and assigned into a research group (n=47) and a control group (n=47). The research group was administered LC within 48 hours after the onset. The control group was administered LC 48 hours after the onset. The two groups were compared for perioperative parameters, bilirubin and immune function, concentration of inflammatory factors, stress response, energy metabolism, and complications. RESULTS: The research group had a shorter operation time, hospital stay, and less intraoperative blood loss than the control group (all P<0.05). No significant intergroup difference was found in the anal exhaust time (P>0.05). The levels of postoperative direct bilirubin, total bilirubin, γ-glutamyl transpeptidase, alkaline phosphatase, serum CRP, TNF-α, and IL-6 were lower than those measured preoperatively in both groups (all P<0.001), and were lower in the research group than in the control group (all P<0.05). The postoperative pulse, diastolic pressure, and systolic pressure in the two groups were higher than those measured preoperatively (all P<0.001). The levels in the research group were lower than those in the control group (all P<0.001).The levels of adenosine triphosphate and adenosine diphosphate also decreased in both groups, but they were still higher in the research group than those in the control group (all P<0.001). The incidence of complications in the research group (4.26%) was lower than that in the control group (17.02%; P<0.05). CONCLUSION: Early LC in elderly patients with AC is beneficial to postoperative functional rehabilitation, showing less impact on energy metabolism, lower stress response caused by surgery, lower bilirubin content, less inflammatory reaction, better liver function, and lower incidence of complications in patients. AJTR
OBJECTIVE: To discuss the effect of the timing of laparoscopic cholecystectomy (LC) on postoperative efficacy and rehabilitation in elderly patients with acute cholecystitis (AC). METHODS: Ninety-four elderly patients with AC were retrospectively selected and assigned into a research group (n=47) and a control group (n=47). The research group was administered LC within 48 hours after the onset. The control group was administered LC 48 hours after the onset. The two groups were compared for perioperative parameters, bilirubin and immune function, concentration of inflammatory factors, stress response, energy metabolism, and complications. RESULTS: The research group had a shorter operation time, hospital stay, and less intraoperative blood loss than the control group (all P<0.05). No significant intergroup difference was found in the anal exhaust time (P>0.05). The levels of postoperative direct bilirubin, total bilirubin, γ-glutamyl transpeptidase, alkaline phosphatase, serum CRP, TNF-α, and IL-6 were lower than those measured preoperatively in both groups (all P<0.001), and were lower in the research group than in the control group (all P<0.05). The postoperative pulse, diastolic pressure, and systolic pressure in the two groups were higher than those measured preoperatively (all P<0.001). The levels in the research group were lower than those in the control group (all P<0.001).The levels of adenosine triphosphate and adenosine diphosphate also decreased in both groups, but they were still higher in the research group than those in the control group (all P<0.001). The incidence of complications in the research group (4.26%) was lower than that in the control group (17.02%; P<0.05). CONCLUSION: Early LC in elderly patients with AC is beneficial to postoperative functional rehabilitation, showing less impact on energy metabolism, lower stress response caused by surgery, lower bilirubin content, less inflammatory reaction, better liver function, and lower incidence of complications in patients. AJTR
Authors: A J Sutton; R S Vohra; M Hollyman; P J Marriott; A Buja; D Alderson; S Pasquali; E A Griffiths Journal: Br J Surg Date: 2016-10-20 Impact factor: 6.939
Authors: Christopher W Mangieri; Bryan P Hendren; Matthew A Strode; Bradley C Bandera; Byron J Faler Journal: Surg Endosc Date: 2018-07-13 Impact factor: 4.584
Authors: A Lauro; S Vaccari; M Cervellera; Giuseppina Casella; V D'Andrea; F M Di Matteo; A Panarese; A Santoro; R Cirocchi; V Tonini Journal: G Chir Date: 2018 Mar-Apr