【进展】白天进行胆囊切除手术对急性胆囊炎的治疗可能会更好

Daytime Cholecystectomy May Be Better for Acute Cholecystitis
白天进行胆囊切除手术对急性胆囊炎的治疗可能会更好
根据《美国外科杂志》于9月20日在网上发表的一项研究文章表明，急性胆囊炎患者若如果在白天而非夜间进行胆囊炎切除手术，更有可能需进行最低限度的侵入性手术。洛杉矶医学生物研究所的医学博士丹尼斯?金及其同事对来自两所大型的城市转诊中心的1140名急性胆囊炎患者进行的夜间手术（晚上7点到早晨7点）和白天手术（早上7点到下午7点）的数据进行了检测与分析。研究者发现夜间手术具有明显较高的转换率进行开腹胆囊切除术（比例达到11:6）。同白天相比，夜间进行的胆囊切除术并没有很大程度上影响到手术后康复住院时间的长短和并发症频率的高低。独立预测开腹胆囊切除术的因素包括夜晚进行胆囊切除术，年龄和坏疽性胆囊炎，而唯一不确定的预测因素是坏疽性胆囊炎。

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Patients who require cholecystectomy for acute cholecystitis are more likely to have a minimally invasive procedure if they have the surgery during daytime rather than at night, according to a study published online Sept. 20 in the American Journal of Surgery.
Dennis Kim, M.D., of the Los Angeles Biomedical Research Institute, and colleagues examined data from 1,140 patients at two large urban referral centers with acute cholecystitis who underwent daytime (7 a.m. to 7 p.m.) versus nighttime (7 p.m. to 7 a.m.) cholecystectomy.
The researchers found that nighttime cholecystectomy was significantly associated with a higher conversion rate to open cholecystectomy (11 versus 6 percent). Nighttime cholecystectomy was not found to significantly affect overall length of stay or complication rate compared with daytime. Independent predictors of conversion to open surgery were nighttime cholecystectomy, age, and gangrenous cholecystitis, while the only predictor of complications was gangrenous cholecystitis.
"The urgency of removing the gallbladder is a topic of much debate among medical professionals," Kim said in an institute news release. "We found patients who underwent the surgery during normal working hours were more likely to have the minimally invasive surgical procedure than those undergoing the procedure at night. Those undergoing nighttime surgeries -- to a greater extent -- experienced more invasive gallbladder removal."
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