Percutaneous cholecystostomy in critically ill patients with a cholecystitis: a safe option
| Autor: | I. van Munster, B. Koebrugge, M. van Leuken, Miranda F. Ernst, Koop Bosscha |
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| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment macromolecular substances Comorbidity Radiography Interventional Standard procedure Catheterization hemic and lymphatic diseases Sepsis medicine Acute cholecystitis Cholecystitis Percutaneous cholecystostomy Humans In patient Cholecystostomy Aged Retrospective Studies Aged 80 and over Critically ill business.industry General surgery Gastroenterology Middle Aged medicine.disease Surgery Acute Disease Drainage Cholecystectomy Female business |
| Zdroj: | Digestive surgery. 27(5) |
| ISSN: | 1421-9883 |
| Popis: | Background: Cholecystectomy is the standard procedure in patients with acute cholecystitis. However, some patients might not be able to undergo immediate surgery because of severe sepsis or underlying comorbid conditions. Percutaneous cholecystostomy is a minimally invasive radiological procedure under local anesthesia which seems to be an effective alternative to conservative treatment or immediate laparoscopic/open cholecystectomy. Methods: We retrospectively analyzed 35 patients who underwent percutaneous cholecystostomy between 2003 and 2009. Results: Percutaneous cholecystostomy was technically successful in all patients. Symptoms resolved within 3 days in 33/35 patients. Two patients needed an emergency laparotomy. The catheter dislodged in 5 patients and was replaced in 2/5. The 30-day mortality rate was 3/35 (8.7%) due to gallbladder necrosis, myocardial infarction and multiorgan failure. Median length of hospital stay was 17 days and median drainage time was 28 days. 23 patients (66%) underwent open or laparoscopic cholecystectomy after a median interval of 44 days. Conclusion: Percutaneous cholecystostomy is an effective procedure and a good alternative for patients unfit to undergo immediate surgery because of severe sepsis or underlying comorbid conditions, preferably followed by interval cholecystectomy to prevent recurrent cholecystitis. |
| Databáze: | OpenAIRE |
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