Emerging indications for percutaneous cholecystostomy for the management of acute cholecystitis – A retrospective review

Nasim, Sana; Khan, Sadaf Irshad; Alvi, Rehman; Chaudhary, Moaz

doi:10.1016/j.ijsu.2011.04.008

Cited by 42 publications

(33 citation statements)

References 11 publications

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“…Excluding patients with limited life expectancy caused by advanced malignancy or in rare circumstances when PC is contraindicated, PC is considered the treatment of choice for patients who are not candidates for cholecystectomy [2,5,6]. PC has been shown to be lifesaving in high-risk patients [7] and should be considered a reasonable option in the therapeutic spectrum for patients with both acalculous and calculous AC as a temporizing measure while awaiting resolution of sepsis and optimization of comorbidities before performing the elective surgery or also as a definite treatment, especially in acalculous forms [7][8][9]. PC seems especially useful for certain categories of patients such as patients in intensive care (where the prevalence of acalculous cholecystitis can be as high as 10 %) and in pregnant women where medical treatment alone for cholecystitis is often not successful [2].…”

Section: Percutaneous Cholecystostomy and Its Role In Management Acutmentioning

confidence: 99%

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

Blanco

Pico

2015

J Ultrasound

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Acute cholecystitis is a frequent condition. Although cholecystectomy is the indicated treatment of this entity, it cannot be performed in some high-risk surgery patients, such as critically ill or those with multiple comorbidities. In these non-uncommon scenarios, percutaneous cholecystostomy is the recommended alternative treatment, which allows immediate decompression and drainage of the acutely inflamed gallbladder and thus reducing the patient's symptoms and the systemic inflammatory response. Ultrasound is the imaging method of choice to guide the percutaneous cholecystostomy procedure due to its real-time guidance, lack of ionizing radiation and portability, avoiding the need to transfer unhealthy patients to the radiology department. We will review the ultrasound-guided percutaneous cholecystostomy procedure, of special interest for radiologists, surgeons, and also intensive care and emergency physicians.Keywords Acute cholecystitis Á Interventional radiology Á Ultrasonography Á Cholecystostomy Sommario La colecistiti acuta é una malattia frequente. Benché la colecistectomia laparotomica sia una procedura validata essa non è idonea nella popolazione ad alto rischio, quali i pazienti critici o quelli con elevate comorbiditá. In tali categorie il trattamento percutaneo é la procedura suggerita consentendo di decomprimere la colecisti e ridurre i sintomi sirs correlati. La metodica eco assistita real time e la procedura di scelta in considerazione della assenza di radiazioni e la facilitádi esecuzione in ambiti extra radiologici. Descriveremo di seguito la tecnica di colecistostomia eco guidata di interesse radiologico, chirurgico e rianimatorio.

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Section: Percutaneous Cholecystostomy and Its Role In Management Acutmentioning

confidence: 99%

“…The reported success rate of PC is high (approximately 85 %) and the complications are low (about 10 %) [1,2,8].…”

Section: Percutaneous Cholecystostomy and Its Role In Management Acutmentioning

confidence: 99%

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

Blanco

Pico

2015

J Ultrasound

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“…However, age >70 years is a predictor of failure of conservative treatment [8]. Therefore, PC is a low-risk management option when the patient is too ill to undergo surgery [9].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous cholecystostomy for acute cholecystitis in high‐risk elderly patients

Lin

Chang

Chu

2016

The Kaohsiung J of Med Scie

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Emergency cholecystectomy for acute cholecystitis (AC) is associated with high morbidity and mortality rates in elderly patients with significant comorbidities. The aim of this study was to evaluate percutaneous cholecystostomy for AC in elderly patients with various coexisting diseases. We retrospectively reviewed the records of 4311 patients with AC treated in Mackay Memorial Hospital between the years 2000 and 2015. The clinical course of AC was compared between nonelderly (age ≤70 years) and elderly patients (age>70 years). In total, 67 elderly patients and 32 nonelderly patients received percutaneous cholecystostomy. The rate of percutaneous cholecystostomy increased between the years 2011 and 2015 (from 2.5% to 12.2%) and this procedure was more common in the elderly group (p=0.009). In addition, the comorbidities of ischemic heart disease and chronic kidney disease were higher in elderly than in nonelderly patients (p=0.014 and p=0.015, respectively). The American Society of Anesthesiologists' classification was higher in the elderly patients (p=0.001). The overall survival-free rate of recurrent cholecystitis in patients who did not receive cholecystectomy was not significantly different in the two groups. When compared with emergent cholecystectomy in high-risk elderly patients, percutaneous cholecystostomy resulted in reduced hospital stay and morbidity (p=0.002 and p=0.013, respectively). Our results demonstrate that percutaneous cholecystostomy has become a common and early treatment for AC in high-risk elderly patients with ischemic heart disease or chronic kidney disease. Identifying such patients will possibly improve clinical outcomes, reduce hospital stay and morbidity, and facilitate delayed laparoscopic cholecystectomy.

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“…4,5,10 Image-guided percutaneous cholecystostomy (PC) tube placement has been found to be a safe and effective alternative to cholecystectomy in patients at high risk with serious comorbidities. [11][12][13][14][15][16] This procedure provides an immediate treatment option in these sick patients but is essentially a temporizing measure until the immediate emergency is treated and the patient's medical condition is optimized for an elective cholecystectomy procedure several weeks after placement of the PC tube. 17 Percutaneous cholecystostomy tube placement followed by delayed cholecystectomy has been shown to be an effective treatment option in this high-risk population.…”

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confidence: 99%

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

Molavi

Schellenberg

Christian

2018

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Emerging indications for percutaneous cholecystostomy for the management of acute cholecystitis – A retrospective review

Cited by 42 publications

References 11 publications

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

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

Percutaneous cholecystostomy for acute cholecystitis in high‐risk elderly patients

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

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