【抉择】急性胆囊炎患者应首选急诊手术治疗

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摘要
OBJECTIVE:Acute cholecystitis is a common disease, and laparoscopic surgery is the standard of care.
BACKGROUND:Optimal timing of surgery for acute cholecystitis remains controversial: either early surgery shortly after hospital admission or delayed elective surgery after a conservative treatment with antibiotics.
METHODS:The ACDC ("Acute Cholecystitis-early laparoscopic surgery versus antibiotic therapy and Delayed elective Cholecystectomy") study is a randomized, prospective, open-label, parallel group trial. Patients were randomly assigned to receive immediate surgery within 24 hours of hospital admission (group ILC) or initial antibiotic treatment, followed by delayed laparoscopic cholecystectomy at days 7 to 45 (group DLC). For infection, all patients were treated with moxifloxacin for at least 48 hours. Primary endpoint was occurrence of predefined relevant morbidity within 75 days. Secondary endpoints were as follows: (1) 75-day morbidity using a scoring system; (2) conversion rate; (3) change of antibiotic therapy; (4) mortality; (5) costs; and (6) length of hospital stay.
RESULTS:Morbidity rate was significantly lower in group ILC (304 patients) than in group DLC (314 patients): 11.8% versus 34.4%. Conversion rate to open surgery and mortality did not differ significantly between groups. Mean length of hospital stay (5.4 days vs 10.0 days; P < 0.001) and total hospital costs (

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胆囊是有功能的话 还手术呀

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huierpu 发表于 2014-4-8 00:34
胆囊是有功能的话 还手术呀

可以参考中国胆道外科学组制定的胆系感染诊疗共识（2011董家鸿）。我发的帖子里有。个人目前不支持普遍人群的保胆取石。

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bai48136258 发表于 2014-4-8 06:41
可以参考中国胆道外科学组制定的胆系感染诊疗共识（2011董家鸿）。我发的帖子里有。个人目前不支持普遍人 ...

OBJECTIVE:Acute cholecystitis is a common disease, and laparoscopic surgery is the standard of care.

目的：急性胆囊炎是一种常见的疾病，腹腔镜手术是标准的护理。

BACKGROUND:Optimal timing of surgery for acute cholecystitis remains controversial: either early surgery shortly after hospital admission or delayed elective surgery after a conservative treatment with antibiotics.

背景：急性胆囊炎的手术时机仍存在争议：早期外科住院择期手术或延迟使用抗生素保守治疗后不久。

METHODS:The ACDC ("Acute Cholecystitis-early laparoscopic surgery versus antibiotic therapy and Delayed elective Cholecystectomy") study is a randomized, prospective, open-label, parallel group trial. Patients were randomly assigned to receive immediate surgery within 24 hours of hospital admission (group ILC) or initial antibiotic treatment, followed by delayed laparoscopic cholecystectomy at days 7 to 45 (group DLC). For infection, all patients were treated with moxifloxacin for at least 48 hours. Primary endpoint was occurrence of predefined relevant morbidity within 75 days. Secondary endpoints were as follows: (1) 75-day morbidity using a scoring system; (2) conversion rate; (3) change of antibiotic therapy; (4) mortality; (5) costs; and (6) length of hospital stay.

方法：ACDC（“急性胆囊炎的早期腹腔镜手术和抗生素治疗和延迟择期胆囊切除术”）研究是一项随机，前瞻性，开放标签，平行组试验。患者被随机分配到入院24小时内立即接受手术（集团ILC）或初始抗生素治疗，其次是延迟腹腔镜胆囊切除术在7天到45（集团DLC）。感染，所有患者均至少48小时，莫西沙星治疗。主要终点是75天内发生预定义的相关的发病率。次要终点为：（1）75天的发病率使用的评分系统；（2）的转化率；（3）抗生素治疗的变化；（4）死亡的；（5）和（6）的费用；住院时间。

RESULTS:Morbidity rate was significantly lower in group ILC (304 patients) than in group DLC (314 patients): 11.8% versus 34.4%. Conversion rate to open surgery and mortality did not differ significantly between groups. Mean length of hospital stay (5.4 days vs 10.0 days; P < 0.001) and total hospital costs (

结果：组发病率明显低于控制组（304例）比在DLC（314例）：11.8%和34.4%。开放手术的转化率和死亡率没有群体之间的显著差异。平均住院天数（5.4天和10天；P＜0.001）和总住院费用

不知道 翻译的对不对  里面 没胆结石呀。怎么是保胆取石了。