Percutaneous cholecystostomy in the management of high-risk patients presenting with acute cholecystitis: Timing and outcome at a single institution - 16/08/17
, Ashraf Imam a, b , Guennadi Kouniavsky a, b , Guy Lin a, b , Andrew Zbar a, b, ⁎ , Eli Mavor a, b 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.
Le texte complet de cet article est disponible en PDF.Keywords : Percutaneous cholecystostomy, Acute cholecystitis, Laparoscopic, Conversion
Plan
Vol 214 - N° 3
P. 456-461 - septembre 2017 Retour au numéro
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