Use of Cholecystostomy Tubes in the Management of Patients with Primary Diagnosis of Acute Cholecystitis

Cherng, Nicole; Witkowski, Elan R.; Sneider, Erica B.; Wiseman, Jason T.; Lewis, Joanne; Litwin, Demetrius E. M.; Santry, Heena P.; Cahan, Mitchell A.; Shah, Shimul A.

doi:10.1016/j.jamcollsurg.2011.11.005

Cited by 55 publications

(29 citation statements)

References 10 publications

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“…Hypertension was most common 26 (76.50%), followed by diabetes mellitus 22 (64.70%) and exacerbation of COPD 20 (58.82%). The comorbidity profile of our patients was comparable with that of the patients studied by Nicole Cherng et al [11].…”

Section: Discussionsupporting

confidence: 88%

Percutaneous Cholecystostomy in High Risk Patients with Acute Cholecystitis

Mir¹,

Manzoor²,

Reshi³

et al. 2017

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Aims and Objectives: To assess efficacy and safety of percutaneous cholecystostomy (PC) in high risk patients with acute cholecystitis. Materials and Methods: The study was carried out in high risk patients with acute calculous or acalculous cholecystitis. Patients qualifying for the study were subjected to PC under ultrasound (USG) guidance. A cholecystogram was done postoperatively, to help establish satisfactory catheter position. Results: 24 (70.59%) patients had empyema-gallbladder, 8 (23.53%) had acute calcular cholecystitis and 2 (5.9%) patients were diagnosed as acalcular cholecystitis. None of the patients was fit for general anesthesia at the time of admission. Median hospital-stay after performing procedure was 4 days. Clinical success rate was reported 100% in our study. Bile cultures yielded growth of E Coli in 10 (29.41%), klebsela in 8 (23.53%), pseudomonas aeruginosa in 6 (17.65%) and Proteus mirabilis in 4 (11.8%) of patients. 6 (17.65%) patients did not grow any organism in their bile. Growth noted was sensitive to imipenem 29.41% (10), ciprofloxacin 17.65% (6), levofloxacin 17.65% % (6) and cefuroxime 11.76% (4). No major complication was recorded in our study. No procedure related death was observed. Tube displacement occurred in one patient and minor bleeding was reported in 2 patients. Catheter was removed after a mean of 25.25 days. All patients underwent definitive surgical intervention during the follow up period of 3 months. Conclusion: USG guided PC is a safe and effective procedure for treating high-risk patients who present with acute cholecystitis. Once the acute symptoms diminish or resolve, it should be followed by elective surgery.

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Section: Discussionsupporting

confidence: 88%

Percutaneous Cholecystostomy in High Risk Patients with Acute Cholecystitis

Mir¹,

Manzoor²,

Reshi³

et al. 2017

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“…16,27,28 These studies, however, are limited to relatively small cohorts and lack consistency regarding a delayed versus early laparoscopic cholecystectomy approach after initial PC tube insertion. Furthermore, a 2013 Cochrane review showed that these trials also were not adequately powered, with a high risk of bias and differences in patient inclusion criteria.…”

Section: Discussionmentioning

confidence: 99%

“…4,5,10 Image-guided percutaneous cholecystostomy (PC) tube placement has been found to be a safe and effective alternative to cholecystectomy in patients at high risk with serious comorbidities. [11][12][13][14][15][16] This procedure provides an immediate treatment option in these sick patients but is essentially a temporizing measure until the immediate emergency is treated and the patient's medical condition is optimized for an elective cholecystectomy procedure several weeks after placement of the PC tube. 17 Percutaneous cholecystostomy tube placement followed by delayed cholecystectomy has been shown to be an effective treatment option in this high-risk population.…”

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confidence: 99%

Clinical and operative outcomes of patients with acute cholecystitis who are treated initially with image-guided cholecystostomy

Molavi

Schellenberg

Christian

2018

cjs

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“…The secondary cholecystectomy rates ranged from 57% to 88% [33,34], and this operation is usually performed in patients initially classed ASA 1 or 2 [8], with morbidity rates similar to those after emergency cholecystectomy. The median interval before secondary cholecystectomy was 63 days (range 3 to 1055 days) [33].…”

Section: Follow-upmentioning

confidence: 99%