Percutaneous cholecystostomy for patients with acute cholecystitis and an increased surgical risk
Purpose: To evaluate percutaneous cholecystostomy in patients with acute cholecystitis and an increased surgical risk.
Methods: Thirty-three patients with acute cholecystitis (calculous, n = 22; acalculous, n = 11) underwent percutaneous cholecystostomy by means of a transhepatic (n = 21) or transperitoneal (n = 12) access route. Clinical and laboratory parameters were retrospectively studied to determine the benefit from cholecystostomy.
Results: All procedures were technically successful. Twenty-two (67%) patients improved clinically within 48 hr; showing a significant decrease in body temperature (n = 13), normalization of the white blood cell count (n = 3), or both (n = 6). There were 6 (18%) minor/moderate complications (transhepatic access, n = 3; transperitoneal access, n = 3). Further treatment for patients with calculous cholecystitis was cholecystectomy (n = 9) and percutaneous and endoscopic stone removal (n = 8). Further treatment for patients with acalculous cholecystitis was cholecystectomy (n = 2) and gallbladder ablation (n = 2). There were 4 deaths (12%) either in hospital or within 30 days of drainage; none of the deaths was procedure-related.
Conclusions: Percutaneous cholecystostomy is a safe and effective procedure for patients with acute cholecystitis. For most patients with acalculous cholecystitis percutaneous cholecystostomy may be considered a definitive therapy. In calculous disease this treatment is often only temporizing and a definitive surgical, endoscopic, or radiologic treatment becomes necessary.
|Keywords||Cholecystitis, Cholecystostomy, Gallbladder, calculi, Gallbladder, interventional procedure|
|Persistent URL||dx.doi.org/10.1007/BF02563896, hdl.handle.net/1765/107257|
|Journal||CardioVascular and Interventional Radiology|
van Overhagen, H, Meyers, H, Tilanus, H.W, Jeekel, J, & Laméris, J.S. (1996). Percutaneous cholecystostomy for patients with acute cholecystitis and an increased surgical risk. CardioVascular and Interventional Radiology, 19(2), 72–76. doi:10.1007/BF02563896