PURPOSE: To evaluate the safety and long-term outcome of percutaneous cholecystostomy (PC) under radiologic guidance for acute calculous cholecystitis (ACC) and acute acalculous cholecystitis (AAC) in all patients undergoing that procedure at our institution. MATERIALS AND METHODS: We performed a retrospective analysis of 111 patients who underwent PC from 2004 to 2012. Patients were divided into two groups: AAC and ACC. For all patients, comorbidity and American Society of Anesthesiologists (ASA) classification were determined. The indications, complications, recurrence rate and long-term outcome for both groups were analysed. The mean follow-up was 55 months. RESULTS: Twenty-four patients with AAC and 87 patients with ACC underwent PC. The most common sonographic findings of ACC and AAC were gallbladder wall thickening (90.9%) and hydrops (72.9%). Twelve of 24 patients with AAC (50%) were hospitalized at the Intensive Care Unit (ICU). Overall, the procedure failed in 2 (1.8%) patients. There were 4 (3.6%) abscesses and 2 (1.8%) fistulas post PC. Drain dislodgment was found without sequelae in 8 (7.2%) patients. Elective cholecystectomy was performed in 35/111 (31.5%). Fifty-one of 87 (58.6%) patients with gallstones underwent cholecystectomy; 36/87 (41.3%) did not undergo surgery due to a too short follow-up or death of nonbiliary disease. In the AAC group, there was no recurrent cholecystitis in 17/24 (70.8%) patients; 3/24 (12.5%) underwent surgery and 4/24 (16.6%) patients died in the ICU. CONCLUSION: PC is a minimally invasive treatment with low complication rate for patients with acute cholecystitis whom considered being at high-risk for urgent cholecystectomy. Good selection (ASA III and IV) and indication is needed in patients with ACC before PC because the majority will be operated later on. AAC can be managed nonoperatively and further treatment might not be needed.
PURPOSE: To evaluate the safety and long-term outcome of percutaneous cholecystostomy (PC) under radiologic guidance for acute calculous cholecystitis (ACC) and acute acalculous cholecystitis (AAC) in all patients undergoing that procedure at our institution. MATERIALS AND METHODS: We performed a retrospective analysis of 111 patients who underwent PC from 2004 to 2012. Patients were divided into two groups: AAC and ACC. For all patients, comorbidity and American Society of Anesthesiologists (ASA) classification were determined. The indications, complications, recurrence rate and long-term outcome for both groups were analysed. The mean follow-up was 55 months. RESULTS: Twenty-four patients with AAC and 87 patients with ACC underwent PC. The most common sonographic findings of ACC and AAC were gallbladder wall thickening (90.9%) and hydrops (72.9%). Twelve of 24 patients with AAC (50%) were hospitalized at the Intensive Care Unit (ICU). Overall, the procedure failed in 2 (1.8%) patients. There were 4 (3.6%) abscesses and 2 (1.8%) fistulas post PC. Drain dislodgment was found without sequelae in 8 (7.2%) patients. Elective cholecystectomy was performed in 35/111 (31.5%). Fifty-one of 87 (58.6%) patients with gallstones underwent cholecystectomy; 36/87 (41.3%) did not undergo surgery due to a too short follow-up or death of nonbiliary disease. In the AAC group, there was no recurrent cholecystitis in 17/24 (70.8%) patients; 3/24 (12.5%) underwent surgery and 4/24 (16.6%) patients died in the ICU. CONCLUSION: PC is a minimally invasive treatment with low complication rate for patients with acute cholecystitis whom considered being at high-risk for urgent cholecystectomy. Good selection (ASA III and IV) and indication is needed in patients with ACC before PC because the majority will be operated later on. AAC can be managed nonoperatively and further treatment might not be needed.
Authors: Christina A Fleming; M Ismail; R G Kavanagh; H M Heneghan; R S Prichard; J Geoghegan; D P Brophy; E W McDermott Journal: J Gastrointest Surg Date: 2019-03-18 Impact factor: 3.452
Authors: Massimo Sartelli; Alain Chichom-Mefire; Francesco M Labricciosa; Timothy Hardcastle; Fikri M Abu-Zidan; Abdulrashid K Adesunkanmi; Luca Ansaloni; Miklosh Bala; Zsolt J Balogh; Marcelo A Beltrán; Offir Ben-Ishay; Walter L Biffl; Arianna Birindelli; Miguel A Cainzos; Gianbattista Catalini; Marco Ceresoli; Asri Che Jusoh; Osvaldo Chiara; Federico Coccolini; Raul Coimbra; Francesco Cortese; Zaza Demetrashvili; Salomone Di Saverio; Jose J Diaz; Valery N Egiev; Paula Ferrada; Gustavo P Fraga; Wagih M Ghnnam; Jae Gil Lee; Carlos A Gomes; Andreas Hecker; Torsten Herzog; Jae Il Kim; Kenji Inaba; Arda Isik; Aleksandar Karamarkovic; Jeffry Kashuk; Vladimir Khokha; Andrew W Kirkpatrick; Yoram Kluger; Kaoru Koike; Victor Y Kong; Ari Leppaniemi; Gustavo M Machain; Ronald V Maier; Sanjay Marwah; Michael E McFarlane; Giulia Montori; Ernest E Moore; Ionut Negoi; Iyiade Olaoye; Abdelkarim H Omari; Carlos A Ordonez; Bruno M Pereira; Gerson A Pereira Júnior; Guntars Pupelis; Tarcisio Reis; Boris Sakakhushev; Norio Sato; Helmut A Segovia Lohse; Vishal G Shelat; Kjetil Søreide; Waldemar Uhl; Jan Ulrych; Harry Van Goor; George C Velmahos; Kuo-Ching Yuan; Imtiaz Wani; Dieter G Weber; Sanoop K Zachariah; Fausto Catena Journal: World J Emerg Surg Date: 2017-07-10 Impact factor: 5.469