The impact of a percutaneous cholecystostomy catheter in situ until the time of cholecystectomy on the development of recurrent acute cholecystitis: a historical cohort study

Hasbahçeci, Mustafa; Cengiz, Merve; Malya, Fatma Ümit; Kunduz, Enver; Memmı, Naim

doi:10.17235/reed.2018.5644/2018

Cited by 14 publications

(11 citation statements)

References 15 publications

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“…In our case, the surgeon on call decided for a temporizing solution to solve the acute condition before de nitive surgery. This choice is supported by several studies suggesting that PC followed by late laparoscopic cholecystectomy is a suitable management for patients with ACC deemed un t for emergency surgery (9,31,32). In a paper of 2016, Popowicz et al, (32) reviewed the medical reports of seven hospitals with 799 pts.…”

Section: Discussionmentioning

confidence: 99%

“…(Table1) Also Wang et al, in another paper, suggested keeping the PC tube in place until cholecystectomy in critically ill patients. However, some other studies report adverse events, one of them (9) indicating that a drainage duration longer than two weeks may be associated with increased recurrence. Other policies have been catheter removal after con rmation of the patency of the cystic duct (8) or until surgery (10,11,12).…”

Section: Discussionmentioning

confidence: 99%

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Multidisciplinary approach to acute cholecystitis in a severely cardiopathic patient. Case report and review of literature

Pantalone

Alemanno

Stefàno

et al. 2020

Preprint

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Background. Acute cholecystitis in severely cardiopathic patient after major cardiac surgery represent a challenge for surgeons. Treatment with cholecystostomy could represent a chance for patients even if there are many topics of greatest debate about it: the technique of performing it (if transhepatic or transpapillary), the timing of optimal duration, the timing of drain removal, the need of further examinations before the removal as well as the timing for definitive surgery. We therefore deemed important to share our experience in the treatment of acute cholecystitis in a severe cardiopathic patient, while attempting to clarify all the major topics related to the management of percutaneous cholecystostomy through a literary review.Case presentation. A 58-year-old severly cardiopathic patient who had undergone surgery for hip replacement, developed an acute calcolous cholecystitis a few days after surgery to resolve which a percutaneous cholecystostomy was the chosen strategy. Two weeks after discharge, a cholangiography through the cholecystostomy and a MRI cholangiopancreatography revealed the presence of stones in the cystic duct and in the ductus choledochus. The definitive treatment was decided after consulting with a multidisciplinary team. An open cholecystectomy with simultaneous removal of the cholecystostomy, endoscopic removal of stones and sphincterotomy of the Oddi papilla was performed. The patient is currently healthy and his heart function is satisfactory. Conclusion. Although early cholecystectomy is the recommended choice for acute cholecystitis, a critically ill patients may benefit from a bridging therapy before definitive surgery. The multidisciplinary approach provided a safer solution for this frail patient.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Multidisciplinary approach to acute cholecystitis in a severely cardiopathic patient. Case report and review of literature

Pantalone

Alemanno

Stefàno

et al. 2020

Preprint

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show abstract

“…Also the optimal duration of PC drainage, as reported in a paper by Hasbahceci et al is still a controversial issue [8]. The suggested time is considered to be three to six weeks, with an average of one month, but Morse et al recommended that the PC tube should remain in place in critically ill patients until cholecystectomy (Table 1) [11].…”

Section: Discussionmentioning

confidence: 99%

“…However, further studies are needed to clarify the timing of PC tube removal before definitive surgery. Furthermore, recurrence after catheter removal is an important issue in patients not undergoing surgical treatment [6,8,11]. [3,4,36,37].…”

Section: Discussionmentioning

confidence: 99%

Multidisciplinary Approach to Acute Cholecystitis in a Severely Cardiopathic Patient: Case Report and Review of Literature on Treatment Strategies

Pantalone¹,

Alemanno²,

Stefàno³

et al. 2020

SCR

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Acute cholecystitis in severely cardiopathic patients after major cardiac surgery represents a challenge for surgeons. Treatment with cholecystostomy, may offer a chance to these patients, however there is still a number of controversial issues on the topic: performance surgical techniques (transhepatic or transpapillary), optimal duration and timing of drain removal, the need for further tests before removal as well as the timing for definitive surgery. We therefore deemed it important to share our experience of a multidisciplinary approach for the definitive treatment of this patient with severe heart disease. A percutaneous cholecystostomy was the chosen strategy for a 58-year-old cardiopathic patient who had undergone surgery for hip replacement and had developed acute calculous cholecystitis a few days after surgery. Two weeks after discharge, a cholangiography through the cholecystostomy and an MRI cholangiopancreatography revealed the presence of stones in the cystic duct and in the ductus choledochus. The definitive treatment was decided after consulting with a multidisciplinary team. The choice was to perform an open cholecystectomy with simultaneous removal of the cholecystostomy, endoscopic removal of stones and sphincterotomy of the Oddi papilla. Currently, the patient is healthy and his heart function satisfactory. Although early cholecystectomy is the recommended choice for acute cholecystitis, a patient with severe co-morbidities may benefit from a bridging therapy before definitive surgery and a multidisciplinary approach can provide a safer solution.

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“…Utilization of an SMC without a guidewire access is feasible and safe [9,10]. Additionally, the extra-vascular use of an SMC to navigate difficult obstructions shows promise for patients with obstructive renal calculi, or in this case, cholelithiasis [9].…”

Section: Discussionmentioning

confidence: 99%

Against the Odds: A Novel Technique to Perform Cholangiography from a Percutaneous Approach through the Cystic Duct

Padilla

Hulsberg

Soule

et al. 2018

Cureus

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Percutaneous cholangiography is typically performed via a transhepatic approach and is reserved for patients with contraindications to traditional cholangiogram imaging modalities. For those with suspected cholelithiasis or choledocholithiasis who cannot undergo magnetic resonance imaging for diagnosis, percutaneous cholecystostomy with cholangiogram is a viable option. Endoscopic retrograde cholangiopancreatography may also be precluded due to anatomic or obstructive limitations, in which case, percutaneous transhepatic cholangiography (PTC) may be indicated for diagnosis. PTC may be difficult in a patient with minimal biliary tree dilatation, or tortuous cystic duct anatomy. In cases such as these, a steerable microcatheter (SMC) may be utilized to enable or expedite PTC. The technique to traverse and catheterize the cystic duct and opacify the gallbladder, bile ducts, and duodenum utilizing an SMC is described. This report outlines a non-vascular application of the SMC resulting in a successful cholangiogram, with reduced operative time and thus reduced radiation exposure to the patient.

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The impact of a percutaneous cholecystostomy catheter in situ until the time of cholecystectomy on the development of recurrent acute cholecystitis: a historical cohort study

Abstract: maintaining percutaneous cholecystostomy tubes in place until the time of surgery in surgically fit patients may help to prevent a recurrence after acute calculous cholecystitis.

Cited by 14 publications

References 15 publications

Multidisciplinary approach to acute cholecystitis in a severely cardiopathic patient. Case report and review of literature

Multidisciplinary approach to acute cholecystitis in a severely cardiopathic patient. Case report and review of literature

Multidisciplinary Approach to Acute Cholecystitis in a Severely Cardiopathic Patient: Case Report and Review of Literature on Treatment Strategies

Against the Odds: A Novel Technique to Perform Cholangiography from a Percutaneous Approach through the Cystic Duct

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