关键词: 急性结石性胆囊炎, 手术时机, 腹腔镜胆囊切除术

Abstract: Objective Anti-infection therapy combined with concurrent laparoscopic chole ⁃ cystectomy（LC）is the preferred treatment for acute calculous cholecystitis，but the operation timing has been controversial. This study aims to explore the operation timing in such patients.MethodsA retrospective analysis was conducted on the records of 349 patients who underwent LC for acute calculous cholecystitis. The patients were divided into three groups based on the interval from the onset of symptoms to surgery：Group A（0-3 days，n = 121），Group B （4-7 days，n = 170），and Group C （8-14 days，n = 58）. The parameters examined included demographic information，operation time，length of hospital stay，surgical cost，total cost，complication rates，and mortality across the three groups.ResultsAmong the 349 patients，only 4 patients in group B were converted to laparotomy， while there were no conversion cases in the other two groups. There was no statistically significant difference in conversion rate between the three groups（P = 0. 104）. Similarly， complications occurred in 19 patients，and there was no statistical difference in the incidence of complications between the three groups（P > 0. 05）. There were statistical differences between the three groups in operation time and length of hospital stay（P < 0. 001），and the operation time and length of hospital stay increased significantly with the duration of symptoms. The surgical cost in Group A was significantly lower than in Group B （P < 0. 001）and Group C（P < 0. 001）. The surgical cost in Group C was higher than in Group B，but there was no statistical difference（P = 0. 296）. The total cost in Group A was significantly lower than in Group B（P < 0. 001）and Group C（P < 0. 001）. The total cost in Group C was higher than in Group B，but there was no statistical difference（P = 0. 337）.ConclusionAcute calculous cholecystitis surgery has the best effect within 3 days. During this period，LC can shorten the operation time and length of hospital stay，and reduce the economic burden of patients. Early surgery is also recommended for patients with prolonged symptoms of more than 3 days or even 7 days，but the surgery at this stage is recommended to be done by experienced doctors.

Key words: acute calculous cholecystitis, operation timing, laparoscopic cholecystectomy