Percutaneous Cholecystostomy Versus Laparoscopic Cholecystectomy in Patients With Acute Cholecystitis and Failed Conservative Management

Zehetner, Joerg; Degnera, Evgeniya; Olasky, Jaisa; Mason, Rodney A.; Drangsholt, Siri; Moazzez, Ashkan; Darehzereshki, Ali; Lipham, John C.; Katkhouda, Namir

doi:10.1097/sle.0b013e31829015d2

Cited by 17 publications

(12 citation statements)

References 23 publications

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“…According to a Cochrane systematic review of randomized clinical trials, there was no significant difference seen in morbidity and mortality rates between the two interventions [7]. This was also seen in a retrospective single-institution study between drainage and surgical resection in high-risk patients regarding morbidity (17 vs. 9%, p = 0.67) and mortality (13 vs. 0%, p = 0.23), respectively [8]. It seems that the more recent data is more skewed towards surgical management [2], but given the lack of consensus among physicians and definitive evidence supporting certain criteria for selecting CTP over cholecystectomy in high-risk patients, this management decision is highly dependent on the individual physician’s clinical judgment.…”

Section: Discussionmentioning

confidence: 92%

Percutaneous Cholecystostomy Tube Leading to a “Floating” Gallbladder: A Case Report

Reilly

Dayal

Ogedegbe

et al. 2019

Cureus

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In patients with significant comorbid conditions, acute cholecystitis is managed through surgical intervention or with cholecystostomy tube placement (CTP). The literature is not definitive in its recommendations for cholecystectomy versus cholecystostomy. This case report describes a presentation of acute calculous cholecystitis managed with CTP. Over a 10-week period, due to complications with the tube, the decision was made to perform a cholecystectomy. Upon open surgical exploration, an atraumatic, ruptured, and chronically inflamed gallbladder was found without attachment to the subhepatic plate and, in essence, free “floating” in the peritoneum. To our knowledge, this is the first-known documented case report in the English medical literature. An elderly woman, with significant co-morbidities, following two months of antibiotic treatment for acute cholecystitis and subsequent percutaneous cholecystostomy tube placement and re-placements, underwent elective laparoscopic cholecystectomy, which was converted to open surgery. Upon exploration, a detached, “floating” gallbladder was found posterior to the transverse colon and removed after lysing extensive peritoneal adhesions. Subsequent to the cholecystectomy, the patient had uncomplicated recovery. The literature does not present a clear consensus on CTP use vs early cholecystectomy in high-risk patients with acute cholecystitis. This management decision is based primarily on the surgeon’s clinical judgment and the use of evidence-based risk assessment indices. The "floating gallbladder" is a rare, benign complication that affirms the importance of extensively assessing the risks and benefits of CTP as compared to cholecystectomy in the elderly and/or comorbid patient.

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Section: Discussionmentioning

confidence: 92%

Percutaneous Cholecystostomy Tube Leading to a “Floating” Gallbladder: A Case Report

Reilly

Dayal

Ogedegbe

et al. 2019

Cureus

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“…A total of 89 full‐text articles were assessed for eligibility, and 26 articles were included in the study. Details of relevant excluded studies are shown in Table S1 (supporting information). Of the 26 included articles, 24 were eventually used in the meta‐analysis, because four described the same two studies.…”

Section: Resultsmentioning

confidence: 99%

Systematic review of antibiotic treatment for acute calculous cholecystitis

Dijk

Reuver

Tasma

et al. 2016

British Journal of Surgery

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“…14 In these patients, early introduction of PCT may allow for easier and significantly shorter subsequent surgery. 14,45 Timing of PCT placement, removal and subsequent cholecystectomy…”

Section: Long Term Role Of Pctmentioning

confidence: 99%

“…12 This prevents the formation of adhesions, severe fibrosis and the destruction of anatomical tissue planes, which can make subsequent gallbladder surgery a challenging and at times dangerous endeavour. 14,45 From the available literature, it does seem that the answer to this question is 'as soon as possible'.…”

Section: Long Term Role Of Pctmentioning

confidence: 99%

Percutaneous cholecystostomy… why, when, what next? A systematic review of past decade

Elsharif

Forouzanfar

Oaikhinan

et al. 2018

annals

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Introduction Percutaneous cholecystostomy tube drainage has played a vital role in management of cholecystitis in patients where surgery is not appropriate. However, management differs from unit to unit and even between different consultants in the same unit. We conducted this systematic review to understand which of these resulted in the best patient outcomes. Methods We conducted a systematic review using the PubMed database for publication between January 2006 to December 2016. Keyword variants of ‘cholecystostomy’ and ‘cholecystitis’ were combined to identify potential relevant papers for inclusion. Findings We identified 46 studies comprising a total of 312,085 patients from 20 different countries. These papers were reviewed, critically appraised and summarised in table format. Percutaneous cholecystostomy tube drainage is an important treatment modality with an excellent safety profile. It has been used successfully both as a definitive procedure and as a bridge to surgery. There continues to be great variation, however, when it comes to the indications, timing and management of these drains. As far as we are aware, this is the only systematic review to cover the past 10 years. It provides a much-needed update, considering all the technological development and new treatment options in laparoscopic surgery and interventional radiology.

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Percutaneous Cholecystostomy Versus Laparoscopic Cholecystectomy in Patients With Acute Cholecystitis and Failed Conservative Management

Abstract: In this matched cohort analysis, PC failed to show a significant reduction in morbidity compared with LC and was associated with a significantly longer hospital stay.

Cited by 17 publications

References 23 publications

Percutaneous Cholecystostomy Tube Leading to a “Floating” Gallbladder: A Case Report

Percutaneous Cholecystostomy Tube Leading to a “Floating” Gallbladder: A Case Report

Systematic review of antibiotic treatment for acute calculous cholecystitis

Percutaneous cholecystostomy… why, when, what next? A systematic review of past decade

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