Complication Rate of Ultrasound-Guided Percutaneous Cholecystostomy in Patients With Coagulopathy

Abstract

There is no difference in the complication rate for ultrasound-guided percutaneous cholecystostomy in patients who are coagulopathic compared with those who have normal coagulation.

Ultrasound-guided percutaneous cholecystostomy in acute cholecystitis: case vignette and review of the technique

“…The definite and recommended treatment of AC is cholecystectomy [1][2][3]. Alternative treatment options in patients unsuitable for surgery are PC and EUS-guided transgastric/transduodenal gallbladder drainage [2,5,6].…”

“…However, coagulation disorders should be considered as a relative contraindication to perform a transhepatic approach since no differences have been found in the complication rate of US-PC in patients who are coagulopathic compared with those who have normal coagulation [3].…”

“…However, cholecystectomy being performed for acute calculous or acalculous cholecystitis conveys significant morbidity and mortality rates in high-risk surgical patients, such as elderly patients or those critically ill or with multiple comorbidities [3]. The morbidity and mortality rate in these subgroups may reach up to 30 % [1][2][3]. Therefore, more appropriate treatment modalities for high-risk patients with AC should be considered [4].…”

“…Therefore, more appropriate treatment modalities for high-risk patients with AC should be considered [4]. At respect, management with antibiotics and decompression of the gallbladder with percutaneous cholecystostomy (PC) is often used in treating this group of patients [3,4].…”

“…Image guidance for PC is achieved using ultrasound, fluoroscopy, or computed tomography [1]. Ultrasound guidance is the most common and is performed at the bedside avoiding the need to transfer of patients to the operating room or radiology department [1,3].…”