Is percutaneous cholecystostomy safe and effective in acute cholecystitis? Analysis of adverse effects associated with the technique.

Autor: Bejarano González N; Unidad de Cirugía Hepato-Bilio-Pancreática, Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari Parc Taulí, Sabadell, Barcelona, Spain. Electronic address: nbejaranog74@gmail.com., Romaguera Monzonís A; Unidad de Cirugía Hepato-Bilio-Pancreática, Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari Parc Taulí, Sabadell, Barcelona, Spain., Rebasa Cladera P; Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari Parc Taulí, Sabadell, Barcelona, Spain., García Monforte N; Unidad de Cirugía Hepato-Bilio-Pancreática, Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari Parc Taulí, Sabadell, Barcelona, Spain., Labró Ciurans M; Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari Parc Taulí, Sabadell, Barcelona, Spain; Servicio de Cirugía General y del Aparato Digestivo, Althaia Xarxa Assistencial Universitària, Manresa, Barcelona, Spain., Badia Closa J; Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari Parc Taulí, Sabadell, Barcelona, Spain., Criado Paredes E; Unidad de Radiología Vascular Intervencionista, Servicio de Radiología, UDIAT Centro Diagnóstico, Hospital Universitari Parc Taulí, Sabadell, Barcelona, Spain., García Borobia FJ; Unidad de Cirugía Hepato-Bilio-Pancreática, Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari Parc Taulí, Sabadell, Barcelona, Spain.
Jazyk: angličtina
Zdroj: Cirugia espanola [Cir Esp (Engl Ed)] 2022 May; Vol. 100 (5), pp. 281-287. Date of Electronic Publication: 2022 Apr 26.
DOI: 10.1016/j.cireng.2022.04.002
Abstrakt: Introduction: The main objective of our study is to assess the safety and efficacy of percutaneous cholecystostomy for the treatment of acute cholecystitis, determining the incidence of adverse effects in patients undergoing this procedure.
Material and Method: Observational study with consecutive inclusion of all patients diagnosed with acute cholecystitis for 10 years. The main variable studied was morbidity (adverse effects) collected prospectively. Minimum one-year follow-up of patients undergoing percutaneous cholecystostomy.
Results: Of 1223 patients admitted for acute cholecystitis, 66 patients required percutaneous cholecystostomy. 21% of these have presented some adverse effect, with a total of 22 adverse effects. Only 5 of these effects, presented by 5 patients (7.6%), could have been attributed to the gallbladder drainage itself. The mortality associated with the technique is 1.5%. After cholecystostomy, one third of the patients (22 patients) have undergone cholecystectomy. Urgent surgery was performed due to failure of percutaneous treatment in 2 patients, and delayed in another 2 patients due to recurrence of the inflammatory process. The rest of the cholecystectomized patients underwent scheduled surgery, and the procedure could be performed laparoscopically in 16 patients (72.7%).
Conclusion: We consider percutaneous cholecystostomy as a safe and effective technique because it is associated with a low incidence of morbidity and mortality, and it should be considered as a bridge or definitive alternative in those patients who do not receive urgent cholecystectomy after failure of conservative antibiotic treatment.
(Copyright © 2021 AEC. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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