Outcome After Percutaneous Cholecystostomy for Acute Cholecystitis: a Single-Center Experience
| Autor: | Chien Wei Su, Han-Chieh Lin, Yun Cheng Hsieh, Chia Jen Liu, Chun Ku Chen, Che Chang Chan, Teh Ia Huo, Wen Liang Fang, Kuei Chuan Lee |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty medicine.medical_treatment Cholecystitis Acute Single Center Postoperative Complications Recurrence medicine Acute cholecystitis Humans Percutaneous cholecystostomy Cholecystectomy High surgical risk Hospital Mortality Cholecystostomy Aged Proportional Hazards Models Retrospective Studies Aged 80 and over business.industry General surgery Gastroenterology Retrospective cohort study Middle Aged medicine.disease Alternative treatment C-Reactive Protein Logistic Models Treatment Outcome Multivariate Analysis Cholecystitis Female Surgery business Biomarkers Follow-Up Studies |
| Zdroj: | Journal of Gastrointestinal Surgery. 16:1860-1868 |
| ISSN: | 1873-4626 1091-255X |
| Popis: | Percutaneous cholecystostomy is an alternative treatment for acute cholecystitis patients with high surgical risk.One hundred and sixty-six patients consecutively treated by percutaneous cholecystostomy for acute cholecystitis in a single medical center were retrospectively reviewed.The cohort included 121 males and 45 females with mean age of 75.9 years. The overall inhospital mortality rate was 15.1 % (n = 25). Elevated serum creatinine level at diagnosis [odds ratio (OR) 1.497; p = 0.020], septic shock (OR 11.755; p = 0.001), and development of cholecystitis during admission (OR 7.256; p = 0.007) were predictive of inhospital mortality. Of 126 patients who recovered from calculous cholecystitis, 11 experienced recurrent cholecystitis within 2 months. Serum C-reactive protein (CRP) level15 mg dl(-1) at diagnosis [hazard ratio (HR) 10.141; p = 0.027] and drainage duration of cholecystostomy longer than 2 weeks (HR 3.638; p = 0.039) were independent risk factors of early recurrence. The 53 patients who underwent cholecystectomy had an 18.9 % perioperative complication rate and no operation-related mortality.In-patients or those with septic shock or renal insufficiency have worse outcome. Prolonged drainage duration and high CRP level predict early recurrence. Removal of the drainage tube is recommended after resolution of the acute illness. |
| Databáze: | OpenAIRE |
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