Percutaneous cholecystostomy in patient at high risk

Sk, Teplick; Brandon, JC; Haskin, Pamela H.; Pavlides, Constantinos; As, Huppert

doi:10.1080/00325481.1987.11699676

Cited by 7 publications

(2 citation statements)

References 10 publications

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“…The principal disadvantages of this tech nique are the risks inherent to the percuta neous approach, and the relatively small number of cases in published series [29][30][31].…”

Section: Resultsmentioning

confidence: 99%

State of the Art in the Diagnosis and Management of Acute Cholecystitis

Reiss

Deutsch

1993

Dig Dis

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The analysis of 664 cases operated upon for acute cholecystitis as well as a review of the literature indicate the dramatic increase in the age of patients presenting with this complication. Other obvious changes: increasing rate of diabetes mellitus and acalculous cholecystitis. The development of preoperative and operative sonography has contributed greatly to the safety of surgery for acute cholecystitis. The majority of patients classified as having low risks should, at the present state of our knowledge, undergo early and definitive surgery. This approach has shown to be the most benefical from both the medical and economic standpoint. High risk patients as well as patients refusing surgery are optimally treated by sonar-guided percutaneous transhepatic cholecystostomy. Among the recent changes observed over the last 5 years, a marked decrease in septic complications as well as in the length of hospital stay was noted. Both changes improve the cost-benefit ratio of early surgery in this condition.

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“…The principal disadvantages of this tech nique are the risks inherent to the percuta neous approach, and the relatively small number of cases in published series [29][30][31].…”

Section: Resultsmentioning

confidence: 99%

State of the Art in the Diagnosis and Management of Acute Cholecystitis

Reiss

Deutsch

1993

Dig Dis

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“…For patients with acute calculous or acalculous chole cystitis at high risk for abdominal surgery, a recently developed method may be the solution -percutaneous sonography-guided cholecystotomy [11,12], This tech nique, when successful, provides prompt relief of symp toms accompanied by reduced fever and hyperbilirubi nemia. The percutaneous approach could be dangerous, and it is not clear from the literature whether gangrene of the gallbladder can be treated in this way.…”

Section: Discussionmentioning

confidence: 99%

Gangrenous Cholecystitis: Seventeen Years of Experience

Landau¹,

Watemberg²,

Kött³

et al. 1995

Dig Surg

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Background: Gangrenous cholecystitis is a potentially lethal disease. We evaluated the magnitude of this complication from the aspect of pre- and postoperative findings and examined statistical trends. Methods: All patients who had undergone cholecystectomy for a benign lesion in our center over a 17-year period were retrospectively screened. Patients with acute cholecystitis and histological gangrenous changes in the gallbladder wall were compared with patients with acute cholecystitis and no histological gangrenous changes. Results: Of the 3,200 consecutive patients operated on for benign biliary disease, 664 were hospitalized for acute cholecystitis; 174 of these had gangrenous changes in the gallbladder wall. The positive findings were: (1) a trend towards an increase in the number of patients showing gangrenous changes within the last few years; (2) a higher rate of diabetes mellitus in the gangrenous group; (3) a higher rate of a calculus cholecystitis in the gangrenous group, and (4) a higher mortality rate in the gangrenous group. Conclusions: The frequency of gangrenous changes in the gallbladder wall as a complication of acute cholecystitis is steadily increasing. It is possible to predict such changes using preoperative and sonographic data. Prompt surgery under wide-spectrum antibiotic coverage is the key to successful treatment.

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