Dec 1, 1996

An alternative approach to acute cholecystitis. Percutaneous cholecystostomy and interval laparoscopic cholecystectomy

Surgical Endoscopy
E J PattersonJ K MacFarlane

Abstract

The mainstay of therapy for acute cholecystitis is cholecystectomy, which has a mortality of 5-30% in high-risk patients such as the elderly or critically ill. An alternative treatment option in patients suffering from acute cholecystitis with contraindications to emergency surgery is percutaneous cholecystostomy (PC) followed by interval laparoscopic cholecystectomy. Percutaneous cholecystostomy yields 10-12% mortality in high-risk patients and is therefore a safe temporizing measure, allowing delayed, elective cholecystectomy when the patient is in better condition for surgery. Hospital charts and radiology films were reviewed for all 50 patients who underwent PC for acute cholecystitis between January 1990 and September 1993. Most patients were high risk for emergency cholecystectomy by virtue of their critical illness or underlying medical condition. Twenty-five patients went on to have interval cholecystectomies. We recorded whether they underwent laparoscopic or open cholecystectomy, as elective or emergency procedures, and we recorded direct complications, mortality, and postoperative length of hospital stay. Relief of symptoms occurred within 48 h of PC in 90% of patients, and two patients had complications of PC. Lapar...Continue Reading

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Mentioned in this Paper

Acute Disease
Radiology Studies
Elective Surgical Procedures
Cholecystectomy Procedure
Postcholecystectomy Syndrome
Bile Duct Structure
Cholecystectomy, Laparoscopic
Radiographic Imaging Procedure
Dyskinesia, Drug-Induced
Laparoscopy

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