Emergency cholecystectomy vs percutaneous cholecystostomy plus delayed cholecystectomy for patients with acute cholecystitis

Karakayalı, Feza; Akdur, Aydıncan; Kırnap, Mahir; Harman, Ali; Ekici, Yahya; Moray, Gökhan

doi:10.1016/s1499-3872(14)60045-x

Cited by 59 publications

(42 citation statements)

References 31 publications

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“…A large part of this group is likely the acalculous cholecystitis cohort, for whom PC may be definitive treatment. [9] In our study, 9% of cholecystectomies were done within the first 6 weeks after PC, but most (59%) were done between 6 and 12 weeks, which coincides with the majority of recommendations in the literature, [18][19][20][21] and 32% were done after 12 weeks. More than half of the cholecystectomies (64%) were done laparoscopically, while 34% required conversion to open, coinciding with published rates of conversion of 6-35%.…”

Section: Discussionsupporting

confidence: 87%

“…[7] It has also been postulated that cholecystostomy may serve as definitive treatment for cholecystitis, without a need for interval cholecystectomy. [8,9] The indications for cholecystostomy and for interval cholecystectomy are important clinical questions as the extent of biliary disease is increasing. Gallstones affect 10-15% of the adult population, meaning 20-25 million Americans have gallstones, and this number will only continue to rise with the increase in obesity and metabolic syndrome.…”

Section: Ajirmentioning

confidence: 99%

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Ten-year Experience with Percutaneous Cholecystostomy for Acute Cholecystitis in Men

Grisotti

King

Bhattacharya

et al. 2017

AJIR

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Objective: To retrospectively analyze the treatment outcomes of male patients who underwent emergent percutaneous cholecystostomy (PC) for biliary decompression in acute cholecystitis. Methods: A single-institution retrospective analysis of 132 patients from 2003 to 2013. Outcome measures were survival, cholecystostomy drain outcomes, and definitive treatment with surgical cholecystectomy. Results: The patient population was all male, with a mean age of 70.6 years. 79 patients (59.9%) were admitted for biliary disease and 34 patients (25.8%) were in an intensive care unit (ICU) when diagnosed. 18 patients (13.6%) died within 30 days of PC, an additional 12 (9%) died within 6 months of PC, and the median survival was 4.9 years. Multivariate logistic regression showed a direct relationship between 1 month and 6-month mortality with total bilirubin and an inverse relationship with hematocrit. Cox regression analysis for long-term survival revealed increased mortality associated with respiratory failure (hazard ratio [HR]: 2.40, P = 0.023) and total bilirubin (HR: 1.11, P < 0.001); lower mortality was associated with a primary diagnosis of cholecystitis (HR: 0.29, P = 0.010), higher hematocrit (HR: 0.89, P < 0.001), and ICU (HR: 0.17, P = 0.003) and floor (HR: 0.34, P = 0.029) diagnosis location. Only 55 patients (41.7%) proceeded to surgical cholecystectomy. Outcomes at 1 year (n = 110) were 40% alive after surgery, 25.5% alive without surgery or a drain, 2.7% alive without surgery but with a drain, and 31.8% dead. Conclusions: Although PC is associated with a high early mortality, 25.5 % of our patients were definitively treated with cholecystostomy alone. Certain biomarkers and patient characteristics may help model survival after PC.

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Section: Discussionsupporting

confidence: 87%

Section: Ajirmentioning

confidence: 99%

Ten-year Experience with Percutaneous Cholecystostomy for Acute Cholecystitis in Men

Grisotti

King

Bhattacharya

et al. 2017

AJIR

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“…22 Improved outcomes have been shown with delayed cholecystectomy following percutaneous draining in this highrisk cohort. 23 The resolution of the acute episode of cholecystitis after PC tube placement may itself be followed by complications, including a 1-year cholecystitis recurrence rate of up to 35% and 30-day overall mortality rate of up to 15.4%. 24,25 In most studies published after 1995, the overall mortality rate was 13.3%.…”

mentioning

confidence: 99%

Clinical and operative outcomes of patients with acute cholecystitis who are treated initially with image-guided cholecystostomy

Molavi

Schellenberg

Christian

2018

cjs

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“…Some patients underwent LC or conventional cholecystectomy as per the surgeon's preferences. Karakayali et al [26] stated that the rate of conversion to open procedure is high in patients undergoing emergency cholecystectomy. The rates of conversion to conventional cholecystectomy in both groups in the present study are similar to those reported in literature.…”

Section: Discussionmentioning

confidence: 99%

Bridge treatment for early cholecystectomy in geriatric patients with acute cholecystitis; percutaneous cholecystostomy

Zeren¹,

Bayhan²,

Koçak³

et al. 2017

Ulus Travma Acil Cerrahi Derg

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Emergency cholecystectomy vs percutaneous cholecystostomy plus delayed cholecystectomy for patients with acute cholecystitis

Cited by 59 publications

References 31 publications

Ten-year Experience with Percutaneous Cholecystostomy for Acute Cholecystitis in Men

Ten-year Experience with Percutaneous Cholecystostomy for Acute Cholecystitis in Men

Clinical and operative outcomes of patients with acute cholecystitis who are treated initially with image-guided cholecystostomy

Bridge treatment for early cholecystectomy in geriatric patients with acute cholecystitis; percutaneous cholecystostomy

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