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J Korean Soc Emerg Med > Volume 34(1); 2023 > Article
Journal of The Korean Society of Emergency Medicine 2023;34(1): 63-69.
중증 급성 담낭염 환자에서 응급실 내원 후 경피적 담낭배액술 시행까지의 적절한 시간
최준영 , 류현식 , 박성수 , 이재광 , 최현수 , 황승연 , 장지연 , 이세종 , 이혜지
건양대학교병원 응급의학과
Optimal timing for performing percutaneous transhepatic gallbladder drainage to severe acute cholecystitis patients who visit the emergency department
Jun Young Choi , Hyun Sik Ryu , Seong Soo Park , Jae Kwang Lee , Hyun Soo Choi , Seung Yeon Hwang , Ji Yeon Jang , Se Jong Lee , Hye Ji Lee
Department of Emergency Medicine, Konyang University Hospital, Daejeon, Korea
Correspondence  Hyun Sik Ryu ,Tel: 042-600-9119, Fax: 042-600-9026, Email: alsiki@hanmail.net,
Received: April 27, 2022; Revised: June 24, 2022   Accepted: June 27, 2022.  Published online: February 28, 2023.
ABSTRACT
Objective:
Severe acute cholecystitis is an infectious disease that requires immediate gallbladder drainage. Although percutaneous transhepatic gallbladder drainage (PTGBD) is the most common method of gallbladder drainage, the optimal timing remains unclear.
Method:
This study is a retrospective analysis of patients diagnosed with severe acute cholecystitis who underwent PTGBD between July 2018 to June 2021. This study investigated the effect of time from emergency department arrival to PTGBD (tPTGBD) on patient prognosis.
Results:
Totally, 48 patients were included in this study. Based on the cutoff value calculated using the Youden index, the group with tPTGBD of <5.93 hours had a shorter hospital stay (10 vs. 13.5 days, P=0.021), lower portion of progression (27:5 [15.6%] vs. 7:9 [56.3%], P=0.004), even they had a higher initial SOFA score (6 vs. 4.6, P=0.049). However, no statistical difference was obtained for the length of ICU stay between both groups (1 vs. 2, P=0.617).
Conclusion:
Executing PTGBD to severe acute cholecystitis patients within 5.93 hours after presenting at the emergency department is associated with reduced progression and hospital stay.
Key words: Acute cholecystitis; Organ dysfunction scores; Cholecystostomy
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