Shiri Zarour1, Ashraf Imam2, Guennadi Kouniavsky3, Guy Lin4, Andrew Zbar5, Eli Mavor6. 1. Department of Surgery, Kaplan Medical Center, Rehovot, Israel; School of Medicine, Hebrew University, Jerusalem, Israel. Electronic address: Shiri.fh@gmail.com. 2. Department of Surgery, Kaplan Medical Center, Rehovot, Israel; School of Medicine, Hebrew University, Jerusalem, Israel. Electronic address: ash_imam04@hotmail.com. 3. Department of Surgery, Kaplan Medical Center, Rehovot, Israel; School of Medicine, Hebrew University, Jerusalem, Israel. Electronic address: guennadiko@clalit.org.il. 4. Department of Surgery, Kaplan Medical Center, Rehovot, Israel; School of Medicine, Hebrew University, Jerusalem, Israel. Electronic address: guy.lin@clalit.org.il. 5. Department of Surgery, Kaplan Medical Center, Rehovot, Israel; School of Medicine, Hebrew University, Jerusalem, Israel. Electronic address: apzbar1355@yahoo.com. 6. Department of Surgery, Kaplan Medical Center, Rehovot, Israel; School of Medicine, Hebrew University, Jerusalem, Israel. Electronic address: eli_m@clalit.org.il.
Abstract
BACKGROUND: Cholecystectomy is the standard of care in acute cholecystitis (AC). Percutaneous cholecystostomy (PC) is an effective alternative for high-risk surgical cases. METHODS: A retrospective analysis is presented of AC patients treated with PC drainage at a single tertiary institution over a 21 month period, assessing outcome and complications. RESULTS: Of 119 patients, 103 had clinical improvement after PC insertion. There were 7 peri-procedural deaths (5.9%), all in elderly high-risk cases. Overall, 56/103 cases (54%) were definitively managed with PC drainage with 41 patients (40%) undergoing an elective cholecystectomy (75% performed laparoscopically). The timing of PC insertion did not affect AC resolution or drain-related complications, although more patients underwent an elective cholecystectomy if PC placement was delayed (>24 h after admission). CONCLUSIONS: In AC, drainage by a PC catheter is a safe and effective procedure. It may be used either as a bridge to elective cholecystectomy or in selected cases as definitive therapy.
BACKGROUND: Cholecystectomy is the standard of care in acute cholecystitis (AC). Percutaneous cholecystostomy (PC) is an effective alternative for high-risk surgical cases. METHODS: A retrospective analysis is presented of AC patients treated with PC drainage at a single tertiary institution over a 21 month period, assessing outcome and complications. RESULTS: Of 119 patients, 103 had clinical improvement after PC insertion. There were 7 peri-procedural deaths (5.9%), all in elderly high-risk cases. Overall, 56/103 cases (54%) were definitively managed with PC drainage with 41 patients (40%) undergoing an elective cholecystectomy (75% performed laparoscopically). The timing of PC insertion did not affect AC resolution or drain-related complications, although more patients underwent an elective cholecystectomy if PC placement was delayed (>24 h after admission). CONCLUSIONS: In AC, drainage by a PC catheter is a safe and effective procedure. It may be used either as a bridge to elective cholecystectomy or in selected cases as definitive therapy.
Authors: Francisco Schlottmann; Charles Gaber; Paula D Strassle; Marco G Patti; Anthony G Charles Journal: J Gastrointest Surg Date: 2018-09-17 Impact factor: 3.452
Authors: Itamar Feldman; Lena Feldman; Dvorah S Shapiro; Gabriel Munter; Amos M Yinnon; Reuven Friedman Journal: Isr J Health Policy Res Date: 2020-08-03