• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.2
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• pp.159-167
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• 2022

Backgrounds/Aims: The optimal timing of percutaneous transhepatic gallbladder drainage (PTGBD) and subsequent laparoscopic cholecystectomy (LC) according to the severity of acute cholecystitis (AC) has not been established yet. Methods: This single-center, retrospective study included 695 patients with grade I or II AC without common bile duct stones who underwent PTGBD and subsequent LC between January 2010 and December 2019. Difficult surgery (DS) (open conversion, subtotal cholecystectomy, adjacent organ injury, transfusion, operation time ≥ 90 minutes, or estimated blood loss ≥ 100 mL) and poor postoperative outcome (PPO) (postoperative hospital stay ≥ 7 days or Clavien-Dindo grade ≥ II postoperative complication) were defined to comprehensively evaluate intraoperative and postoperative outcomes, respectively. Results: Of 695 patients, 403 had grade I AC and 292 had grade II AC. According to the receiver operating characteristic curve and multivariate logistic regression analyses, an interval from symptom onset to PTGBD of > 3.5 days and an interval from PTGBD to LC of > 7.5 days were significant predictors of DS and PPO, respectively, in grade I AC. In grade II AC, the timing of PTGBD and subsequent LC were not statistically related to DS or PPO. Conclusions: In grade I AC, performing PTGBD within 3.5 days after symptom onset can reduce surgical difficulties and subsequently performing LC within 7.5 days after PTGBD can improve postoperative outcomes. In grade II AC, early PTGBD cannot improve the surgical difficulty. In addition, the timing of subsequent LC is not correlated with surgical difficulties or postoperative outcomes.

• Journal of the Korean Society of Radiology
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• v.6 no.1
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• pp.11-17
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• 2012

The purpose of this study is to measure and evaluate radiation dose on patients in interventional radiological(IVR) procedures classified by each procedure, and aid as data for safety management. Fluroscopy time(F-time), dose area product(DAP) and number of acquired images from each kind of procedure was checked. Non-vascular procedures showed low value, and vascular procedure showed high value in all procedures except in IVC filter. F-time was longest in EVAR, which showed also the highest DAP value of all procedures. DAP-rate showed high value in TACE. By this result, we attempt to establish standard guideline of radiation dose on patients in IVR procedure.