Outcome After Percutaneous Cholecystostomy for Acute Cholecystitis: a Single-Center Experience

Hsieh, Yun Cheng; Chen, Chun Ku; Su, Chien–Wei; Chan, Che Chang; Huo, Teh Ia; Liu, Chia Jen; Fang, Wen Liang; Lee, Kuei Chuan; Lin, Han Chieh

doi:10.1007/s11605-012-1965-8

Cited by 72 publications

(74 citation statements)

References 26 publications

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“…25 The rate of complications following LC in the elderly is estimated to be 22%. 5,7,9,[26][27][28] In the present study, a similar rate of major morbidity was observed (23%) to the rates reported for other series of patients undergoing interval cholecystectomy after PCY (Table 4). [2][3][4][5][6][7][8][9]29 Routine drainage at cholecystectomy did not prevent abscess formation in five patients.…”

Section: Surgical Techniquesupporting

confidence: 90%

“…Mortality rates have been reported from 0% to 15% and morbidity rates from 0% to 25%. [2][3][4][5][6][7][8][9] Furthermore, as the majority of patients do not have definitive surgery, recurrent AC is common. 10 This study was performed to quantify the risk of short and long-term morbidity and mortality for this cohort, using recognised scoring systems for co-morbidities and complications.…”

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confidence: 99%

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High rate of common bile duct stones and postoperative abscess following percutaneous cholecystostomy

FurtadoR

DunnG

et al. 2016

annals

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INTRODUCTION The short and long-term outcomes in patients managed with percutaneous cholecystostomy (PCY) at a single institution are described. METHODS A retrospective study was conducted for patients treated between February 2000 and November 2012. Patient charts, imaging and biochemical data were reviewed. Patient demographics, presenting clinical features and treatment variables were noted. Outcome variables were length of admission, 30-day mortality, 30-day unplanned readmission, tube dislodgement, abscess formation, subsequent endoscopic retrograde cholangiography and surgery, complications after surgery and median overall survival. RESULTS PCY was performed for 55 patients for acute cholecystitis where surgical risk was very high. The 30-day readmission rate was 20% (n=11), the 30-day mortality rate was 9% (n=5) and median survival was 59 months (95% confidence interval: 30-88 months). The median follow-up duration was 68 months. Tubes were dislodged in 15 patients (27%) and an abscess occurred after PCY in 5 patients (9%). Subsequent endoscopic common bile duct stone extraction was required in 20 patients (36%). Cholecystectomy was planned in 22 patients and an abscess occurred following the cholecystectomy in 5 (23%). CONCLUSIONS Although a PCY is lifesaving, significant morbidity can arise during recovery. This study demonstrates a high rate of choledocholithiasis (44%), tube dislodgement (27%) and postoperative abscess (23%) compared with previous reports.

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Section: Surgical Techniquesupporting

confidence: 90%

mentioning

confidence: 99%

High rate of common bile duct stones and postoperative abscess following percutaneous cholecystostomy

FurtadoR

DunnG

et al. 2016

annals

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“…[2] PC became a recognized temporizing measure for patients with cholecystitis, either with or without cholelithiasis, who were too debilitated or acutely ill to undergo an emergent surgical cholecystectomy, for which rates of morbidity up to 41% and perioperative mortality up to 18% have been reported. [3] Recently, PC has also been proposed as a preferred therapeutic intervention, sometimes definitively, in pregnant patients [4] and in chronic hemodialysis patients. [5] However, a Cochrane Review from 2013 found that more information is still needed to determine the role of PC in high-risk surgical patients.…”

Section: Introductionmentioning

confidence: 99%

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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“…Percutaneous cholecystostomy (PC) or percutaneous transhepatic gallbladder drainage (PTGBD) is an alternative treatment for acute cholecystitis in patients who are deemed to be at high surgical risk (1). The perioperative mortality rate of early laparoscopic cholecystectomy is about 1% in low-risk patients (2,3), but in patients who are elderly or who have severe comorbidities, the morbidity rises to 41%, and perioperative mortality increases to 18% (1).…”

Section: Introductionmentioning

confidence: 99%

“…The perioperative mortality rate of early laparoscopic cholecystectomy is about 1% in low-risk patients (2,3), but in patients who are elderly or who have severe comorbidities, the morbidity rises to 41%, and perioperative mortality increases to 18% (1). PTGBD is a safer, minimally invasive procedure for high-risk patients who do not respond to conservative treatment.…”

Section: Introductionmentioning

confidence: 99%

Thoracic Empyema Caused by Percutaneous Transhepatic Gallbladder Drainage

et al. 2015

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Percutaneous transhepatic gallbladder drainage (PTGBD) is an alternative to emergency laparoscopic cholecystectomy in high-risk patients with acute cholecystitis. Severe complications of this procedure are rare, except for drainage tube-related complications. A case of thoracic empyema, which is a rare complication of PTGBD, is reported; penetration of the pleural cavity seemed to be the cause of the thoracic empyema.

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Outcome After Percutaneous Cholecystostomy for Acute Cholecystitis: a Single-Center Experience

Abstract: In-patients or those with septic shock or renal insufficiency have worse outcome. Prolonged drainage duration and high CRP level predict early recurrence. Removal of the drainage tube is recommended after resolution of the acute illness.

Cited by 72 publications

References 26 publications

High rate of common bile duct stones and postoperative abscess following percutaneous cholecystostomy

High rate of common bile duct stones and postoperative abscess following percutaneous cholecystostomy

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

Thoracic Empyema Caused by Percutaneous Transhepatic Gallbladder Drainage

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