Objective To investigate thetiming offurtheroperative opportunity for the treatmentofpercutaneous transhepatic gallbladder drainage (PTGD)in patients with acute cholecystitis. Methods Theclinical data of 77 patients with acute cholecystitis who received laparoscopic cholecystectomy after PTGD wereanalyzed retrospectively. According to the interval, Seventy-seven cases weredivided into 3 groups. The patientsin the first (n = 11), second (n = 36), third (n = 30) group performed LC were within 2 m, during 2 ~ 4 m,and beyond 4 m, retrospectively. The rate of conversion to surgery, intraoperative blood, operation time andhospital stay were compared among the three groups. Results There was significant difference in the thicknessof gallbladder wall before LC, conversion to open surgery, intraoperative blood, operation time, hospital stayandpostoperative complications among 3 groups (P < 0.05). Conclusion The timing for LC in patients withacute cholecystitis should be within the 2 ~ 4 mintervalafter PTGD, the thickness of gallbladder wall less than0.42 cm and stable condition. On average LC appearsafe and effective with short operation time , less blood loss,low rate of conversion to open surgery and postoperative complications , reduced hospital stay, and results inbetter quality of life.%目的：探讨急性胆囊炎患者行经皮经肝胆囊穿刺引流术后的进一步手术治疗的时机。方法：回顾性分析我院77例急性胆囊炎患者行经皮经肝胆囊穿刺引流术（percutaneous transhepatic gallbladder drainage，PTGD）后联合腹腔镜胆囊切除术（laparoscopic cholecystectomy，LC）的临床资料。按 PTGD 与 LC 的间隔时间分为三组，组1为 PTGD 后2个月内行 LC 的病例（n ＝11），组2为 PTGD 后2～4个月内行 LC的病例（n ＝36），组3为 PTGD 后间隔4个月以上行 LC 的病例（n ＝30）。比较三组中转率、术中出血量、手术时间、术后住院时间等。结果：三组间，LC 前胆囊壁厚、LC 转开腹例数、术中出血量、手术时间、术后住院时间、术后并发症的比较，差异有统计学意义（P ＜0．05）。结论：急性胆囊炎患者经 PTGD 治疗2～4个月择期手术，B 超检查胆囊壁厚＜0．42 cm，并且患者病情稳定后行 LC，能较好地缩短手术时间，减少术中出血量，降低LC 转开腹率，缩短术后住院时间，降低患者术后切口裂开、感染等并发症的发生，提高患者的生活质量。
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