Comparison of Emergency and Elective Laparoscopic Common Bile Duct Exploration in the Treatment of Choledocholithiasis with Acute Cholangitis Based on Propensity Score Matching
10.11969/j.issn.1673-548X.2024.11.020
- VernacularTitle:基于倾向性评分匹配比较急诊与择期腹腔镜胆总管探查术在胆总管结石合并急性胆管炎中的疗效
- Author:
Weipeng LU
1
;
Qingchun XU
;
Zhigang LIU
Author Information
1. 241000 华东师范大学附属芜湖医院急诊外科
- Publication Type:Journal Article
- Keywords:
Emergency;
Elective;
Laparoscopic common bile duct exploration;
Choledocholithiasis;
Acute cholangitis;
Propensity score matching
- From:
Journal of Medical Research
2024;53(11):100-104
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the clinical efficacy of emergency and elective laparoscopic common bile duct exploration(LCBDE)in the treatment of choledocholithiasis with acute cholangitis based on propensity score matching(PSM).Methods Retro-spective cohort study was used.The clinical data of 162 patients with choledocholithiasis complicated with acute cholangitis who underwent LCBDE in Wuhu Hospital,East China Normal University from January 2021 to October 2023 were retrospectively analyzed.Among them,59 patients underwent emergency LCBDE(emergency group),and 103 patients underwent elective LCBDE after conservative treatment(elective group).The PSM method was used to match the two groups of patients by 1∶1,and the relevant clinical data of the two groups were compared.Results The two groups successfully matched 44 pairs of patients.The intraoperative blood loss in the emergency group was more than that in the elective group(65.00±19.88ml vs 54.89±17.90ml,P=0.014).The use time of antibiotics was lower than that in the elective group(3.68±1.46days vs 5.95±1.46days,P＜0.001).The total hospitalization time was lower than that in the e-lective group[7.0(6.0,8.0)days vs 8.0(7.0,9.0)days,P＜0.001].The hospitalization cost was lower than that in the elective group[1.19(1.10,1.45)ten thousand yuan vs 1.43(1.22,1.67)ten thousand yuan,P=0.001].There was no significant difference in operation time,conversion rate,operation method,peritoneal drainage tube removal time,postoperative hospital stay,and postoperative complication rate between the two groups(P＞0.05).Conclusion Both emergency and elective LCBDE are safe and effective in the treatment of choledocholithiasis with mild to moderate acute cholangitis,but emergency LCBDE has significant advantages in the use of an-tibiotics,total hospitalization time and hospitalization costs.
