Laparoscopic cholecystostomy as an alternative to open cholecystectomy and percutaneous cholecystostomy in a rural setting

Han, Shwe Phyo

doi:10.1016/j.hpb.2016.03.296

Cited by 2 publications

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“…LC tube placement can be used as an alternative to open cholecystectomy in technically difficult cases and alternative to IR percutaneous cholecystostomy in rural hospitals without interventional radiology services. 5 There are other indications for LC tube placement -such as in children with complicated choledochal cyst-where LC tube placement followed by laparoscopic cyst excision is a useful and safe procedure for the treatment of complicated choledochal cyst. This technique is also favorable from a cosmetic viewpoint because the resultant wound can be reused as the trocar insertion site at the time of laparoscopic cyst excision.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic cholecystostomy tube placement

Cheeyandira¹

2020

MOJCR

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Laparoscopic cholecystectomy is one of the most common procedures performed in the world today Acute calculus cholecystitis is the most frequent complication of cholelithiasis. Laparoscopic cholecystectomy is the best treatment for acute calculus cholecystitis when performed within 72 hours. Acute cholecystitis tends to be one of the highest risks for conversion to open surgery-due to unclear anatomy, excessive bleeding or technical complications. Here we present 2 cases with severe acute cholecystitis that required placement of laparoscopic cholecystostomy (LC) tube. Patient subsequently underwent interval cholecystectomy, when the inflammation had subsided. LC tube placement can be a safe alternative in such situations to avoid complications and conversion to open procedure.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic cholecystostomy tube placement

Cheeyandira¹

2020

MOJCR

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“…It is believed to be an effective, minimally invasive, and safer approach to treat patients who are very ill due to ongoing sepsis, have failed medical treatment with antibiotics, or are generally high risk due to their multiple co-morbidities [8]. Although the least invasive approach is the management of such patients with a percutaneous image-guided cholecystostomy, however, in smaller district general hospitals, the lack of availability of radiological services out of hours renders the use of the laparoscopic approach a suitable alternative [9].…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Percutaneous Image-Guided and Laparoscopic Cholecystostomies in High-Risk Patients With Acute Calculus Cholecystitis: A Five-Year District General Hospital Experience

Aly,

Jamal,

Khawaja

et al. 2024

Cureus

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IntroductionAcute cholecystitis (AC), inflammation of the gall bladder, is one of the most common emergency surgical presentations. In the UK, approximately 15% of the population is estimated to have gallstones, and approximately 20% of them can develop AC. Laparoscopic cholecystectomy (LC) is considered the definitive management of AC. However, cholecystectomy carries a very high risk of morbidity and mortality in highrisk frail patients with multiple comorbidities who are deemed unfit for surgery. Percutaneous cholecystostomy (PC), both image-guided and laparoscopic, is generally acknowledged as an interim treatment measure before definitive management, which is the LC. Materials and methodsThis is a retrospective study from the Royal Albert Edward Infirmary, a district general hospital (DGH) based in Wigan, UK. The medical records of all the patients who were admitted to the surgical department and underwent PC between January 2017 and December 2022 were analyzed. Patients with previous hepatopancreato-biliary (HPB) malignancy, who underwent open cholecystostomy, or those with abdominal ascites were excluded from the study. Information was collected regarding the age, gender, American Society of Anaesthesiologists (ASA) grades, success rates of both procedures as temporary or definitive management, duration of hospital stay, 30-day and 1-year mortality after the procedure, timing of the procedure, and long-term complications after the procedure, particularly those related to cholecystostomy tube dislodgment or blockage. ResultsTwenty-seven patients who underwent PC were divided into two groups: group A, consisting of 10 patients who underwent laparoscopic cholecystostomies, and group B, consisting of 17 patients who had ultrasound (US)-guided cholecystostomies. The mean age of the patients in group A was 66.7 as compared to 75.1 in group B. Most of the patients were in ASA groups III (14) and IV (10). About 74% of patients had procedures done during the day and 26% had PC at night time. The mean hospital stay was 13.5 days. About 55% of patients had planned elective LC as a definitive management. Following the treatment, two patients died within 30 days, and eight patients passed away within a year. About 40% of the patients had complications related to the tube dislodgment and blockage. ConclusionThis study concludes that PC, using both laparoscopic and US-guided techniques, can serve as an interim as well as a definitive measure, particularly in patients who are at high risk for anesthesia and the procedure itself and have multiple comorbidities.

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Laparoscopic cholecystostomy as an alternative to open cholecystectomy and percutaneous cholecystostomy in a rural setting

Cited by 2 publications

References 0 publications

Laparoscopic cholecystostomy tube placement

Laparoscopic cholecystostomy tube placement

Outcomes of Percutaneous Image-Guided and Laparoscopic Cholecystostomies in High-Risk Patients With Acute Calculus Cholecystitis: A Five-Year District General Hospital Experience

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