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Percutaneous cholecystostomy: a bridge to surgery or definite management of acute cholecystitis in high-risk patients?

Leveau, Per LU ; Andersson, Ellen LU ; Carlgren, Ingela; Willner, Julian LU and Andersson, Roland LU (2008) In Scandinavian Journal of Gastroenterology 43(5). p.593-596
Abstract
OBJECTIVE: Cholecystectomy is the standard treatment for acute cholecystitis, but in high-risk patients with serious comorbidity and in patients of advanced age there is substantial morbidity and mortality associated with the intervention. In these selected patients, percutaneous cholecystostomy (PCS) is an alternative mode of management. The aim of the present study was to evaluate the outcome of PCS in selected patients with acute cholecystitis. MATERIAL AND METHODS: Thirty-five patients, representing 0.6% of all acute cholecystitis patients managed during the period 1994-2003, were subjected to PCS. Patients' charts were reviewed retrospectively for age, gender, comorbidity, hospital stay, procedure, complications and final outcome,... (More)
OBJECTIVE: Cholecystectomy is the standard treatment for acute cholecystitis, but in high-risk patients with serious comorbidity and in patients of advanced age there is substantial morbidity and mortality associated with the intervention. In these selected patients, percutaneous cholecystostomy (PCS) is an alternative mode of management. The aim of the present study was to evaluate the outcome of PCS in selected patients with acute cholecystitis. MATERIAL AND METHODS: Thirty-five patients, representing 0.6% of all acute cholecystitis patients managed during the period 1994-2003, were subjected to PCS. Patients' charts were reviewed retrospectively for age, gender, comorbidity, hospital stay, procedure, complications and final outcome, including requirement of additional interventions. RESULTS: PCS was considered successful in 34/35 patients, 26 of whom responded within 3 days. Two patients required additional cholecystectomy 3 days and 20 months, respectively, after the PCS procedure. Two patients underwent endoscopic retrograde cholangiopancreatography (ERCP) and one patient underwent rotation lithotripsy. Four patients suffered recurrent biliary complaints after the acute episode of cholecystitis, while the only serious procedure-related complication was bile leakage from the gallbladder in one patient, which necessitated cholecystectomy. CONCLUSIONS: PCS is a comparatively safe and efficient procedure in the treatment of acute cholecystitis in high-risk patients with serious comorbidity and in elderly patients, contraindicating the general anaesthesia required for laparoscopic or open cholecystectomy. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Scandinavian Journal of Gastroenterology
volume
43
issue
5
pages
593 - 596
publisher
Taylor & Francis
external identifiers
  • WOS:000256190000013
  • PMID:18415753
  • Scopus:42149157276
ISSN
1502-7708
DOI
10.1080/00365520701851673
language
English
LU publication?
yes
id
77bd4380-4d5d-45ff-b526-317ca2db8558 (old id 1147331)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/18415753?dopt=Abstract
date added to LUP
2008-05-06 13:56:53
date last changed
2016-11-20 04:21:22
@misc{77bd4380-4d5d-45ff-b526-317ca2db8558,
  abstract     = {OBJECTIVE: Cholecystectomy is the standard treatment for acute cholecystitis, but in high-risk patients with serious comorbidity and in patients of advanced age there is substantial morbidity and mortality associated with the intervention. In these selected patients, percutaneous cholecystostomy (PCS) is an alternative mode of management. The aim of the present study was to evaluate the outcome of PCS in selected patients with acute cholecystitis. MATERIAL AND METHODS: Thirty-five patients, representing 0.6% of all acute cholecystitis patients managed during the period 1994-2003, were subjected to PCS. Patients' charts were reviewed retrospectively for age, gender, comorbidity, hospital stay, procedure, complications and final outcome, including requirement of additional interventions. RESULTS: PCS was considered successful in 34/35 patients, 26 of whom responded within 3 days. Two patients required additional cholecystectomy 3 days and 20 months, respectively, after the PCS procedure. Two patients underwent endoscopic retrograde cholangiopancreatography (ERCP) and one patient underwent rotation lithotripsy. Four patients suffered recurrent biliary complaints after the acute episode of cholecystitis, while the only serious procedure-related complication was bile leakage from the gallbladder in one patient, which necessitated cholecystectomy. CONCLUSIONS: PCS is a comparatively safe and efficient procedure in the treatment of acute cholecystitis in high-risk patients with serious comorbidity and in elderly patients, contraindicating the general anaesthesia required for laparoscopic or open cholecystectomy.},
  author       = {Leveau, Per and Andersson, Ellen and Carlgren, Ingela and Willner, Julian and Andersson, Roland},
  issn         = {1502-7708},
  language     = {eng},
  number       = {5},
  pages        = {593--596},
  publisher    = {ARRAY(0x97afb98)},
  series       = {Scandinavian Journal of Gastroenterology},
  title        = {Percutaneous cholecystostomy: a bridge to surgery or definite management of acute cholecystitis in high-risk patients?},
  url          = {http://dx.doi.org/10.1080/00365520701851673},
  volume       = {43},
  year         = {2008},
}