Is percutaneous cholecystostomy a good alternative treatment for acute cholecystitis in high-risk patients?
Is percutaneous cholecystostomy a good alternative treatment for acute cholecystitis in high-risk patients?
Cholecystectomy is the treatment of choice for acute cholecystitis but the management of high-risk surgical patients is a difficult dilemma. Percutaneous cholecystostomy (PC) could represent a safer and less invasive option. The aim of the study was to assess the outcomes of PC in high-risk patients. This is a retrospective single-center study; data were collected from our hospital electronic record system. From February 2009 to March 2014, there were 753 patients admitted with acute cholecystitis. Of these 39 were considered high risk for surgery and underwent PC during their hospital stay. The radiological approach was transperitoneal in 29 patients and transhepatic in 10 patients. Median follow-up was 19 months. There were 27 males (69.2%) and 12 females (30.8%) with a mean age of 72 years (range 41-90 years). Twenty-seven patients had PC as definitive treatment (group A) and 12 patients as a bridge to cholecystectomy (group B). There were no postprocedure complications. Five patients in group A were readmitted once with another episode of cholecystitis after PC (18.5%), one patient in group B was readmitted with cholecystitis after two years before proceeding to cholecystectomy, and two patients were readmitted after cholecystectomy (16.6%) for intra-abdominal collections treated with percutaneous radiological drainage. Seven patients died (17.9%) as a result of severe biliary sepsis during their index hospital admission. PC is a safe approach in high-risk patients with acute cholecystitis and can provide satisfactory long-term results when cholecystectomy is not a viable option.
Adult, Age Distribution, Aged, Aged, 80 and over, Body Mass Index, Cholecystectomy, Laparoscopic/adverse effects, Cholecystitis, Acute/diagnostic imaging, Critical Illness/mortality, Drainage/methods, Feasibility Studies, Female, Follow-Up Studies, Humans, Male, Middle Aged, Radiography, Interventional/methods, Retrospective Studies, Risk Factors, Survival Analysis, Treatment Outcome
623-627
Papis, Davide
466c8947-15cb-455a-a0ed-16e6d72dea95
Khalifa, Eiman
dd09f776-ee54-4790-81c9-aa8a5fce808c
Bhogal, Ricky
06d670b9-2b06-4fa5-af4f-244e11961632
Nair, Amit
fd381498-2b83-428d-81cb-d15a5069ec29
Khan, Saboor
226e1dd2-af39-40e6-9cb1-d65545e6ffd7
Hamady, Zaed
545a1c81-276e-4341-a420-aa10aa5d8ca8
Ahmed, Jawad
716911d0-4aaa-423e-8111-38feb48c31c5
Marangoni, Gabriele
b876a178-8129-4455-adcf-1f8b04428c2a
1 June 2017
Papis, Davide
466c8947-15cb-455a-a0ed-16e6d72dea95
Khalifa, Eiman
dd09f776-ee54-4790-81c9-aa8a5fce808c
Bhogal, Ricky
06d670b9-2b06-4fa5-af4f-244e11961632
Nair, Amit
fd381498-2b83-428d-81cb-d15a5069ec29
Khan, Saboor
226e1dd2-af39-40e6-9cb1-d65545e6ffd7
Hamady, Zaed
545a1c81-276e-4341-a420-aa10aa5d8ca8
Ahmed, Jawad
716911d0-4aaa-423e-8111-38feb48c31c5
Marangoni, Gabriele
b876a178-8129-4455-adcf-1f8b04428c2a
Papis, Davide, Khalifa, Eiman, Bhogal, Ricky, Nair, Amit, Khan, Saboor, Hamady, Zaed, Ahmed, Jawad and Marangoni, Gabriele
(2017)
Is percutaneous cholecystostomy a good alternative treatment for acute cholecystitis in high-risk patients?
The American surgeon, 83 (6), .
Abstract
Cholecystectomy is the treatment of choice for acute cholecystitis but the management of high-risk surgical patients is a difficult dilemma. Percutaneous cholecystostomy (PC) could represent a safer and less invasive option. The aim of the study was to assess the outcomes of PC in high-risk patients. This is a retrospective single-center study; data were collected from our hospital electronic record system. From February 2009 to March 2014, there were 753 patients admitted with acute cholecystitis. Of these 39 were considered high risk for surgery and underwent PC during their hospital stay. The radiological approach was transperitoneal in 29 patients and transhepatic in 10 patients. Median follow-up was 19 months. There were 27 males (69.2%) and 12 females (30.8%) with a mean age of 72 years (range 41-90 years). Twenty-seven patients had PC as definitive treatment (group A) and 12 patients as a bridge to cholecystectomy (group B). There were no postprocedure complications. Five patients in group A were readmitted once with another episode of cholecystitis after PC (18.5%), one patient in group B was readmitted with cholecystitis after two years before proceeding to cholecystectomy, and two patients were readmitted after cholecystectomy (16.6%) for intra-abdominal collections treated with percutaneous radiological drainage. Seven patients died (17.9%) as a result of severe biliary sepsis during their index hospital admission. PC is a safe approach in high-risk patients with acute cholecystitis and can provide satisfactory long-term results when cholecystectomy is not a viable option.
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Published date: 1 June 2017
Keywords:
Adult, Age Distribution, Aged, Aged, 80 and over, Body Mass Index, Cholecystectomy, Laparoscopic/adverse effects, Cholecystitis, Acute/diagnostic imaging, Critical Illness/mortality, Drainage/methods, Feasibility Studies, Female, Follow-Up Studies, Humans, Male, Middle Aged, Radiography, Interventional/methods, Retrospective Studies, Risk Factors, Survival Analysis, Treatment Outcome
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Local EPrints ID: 455826
URI: http://eprints.soton.ac.uk/id/eprint/455826
ISSN: 0003-1348
PURE UUID: 5ddd4b95-1d75-4ae6-b1f7-1005cc5c8692
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Date deposited: 05 Apr 2022 17:34
Last modified: 06 Apr 2022 02:01
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Contributors
Author:
Davide Papis
Author:
Eiman Khalifa
Author:
Ricky Bhogal
Author:
Amit Nair
Author:
Saboor Khan
Author:
Zaed Hamady
Author:
Jawad Ahmed
Author:
Gabriele Marangoni
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