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Isr Med Assoc J. 2003 Mar;5(3):170-1.

Percutaneous cholecystostomy in the management of acute cholecystitis.

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  • 1Department of Radiology, Shaare Zedek Medical Center, Jerusalem, Israel.

Abstract

BACKGROUND:

The mainstay of therapy for acute cholecystitis is cholecystectomy, which has a mortality of 14-30% in high risk patients. An alternative approach in patients suffering from acute cholecystitis with contraindications to emergency surgery is percutaneous cholecystostomy.

OBJECTIVE:

To evaluate the efficacy and safety of percutaneous cholecystostomy as the initial treatment of acute cholecystitis in high risk patients.

METHODS:

Eighty consecutive patients (42 men, 38 women) underwent ultrasound-guided percutaneous cholecystostomy over a 5 year period. Sixty-five patients suffered from acute calculous cholecystitis, 4 patients had acalculous cholecystitis, and 11 patients had sepsis of unknown origin.

RESULTS:

Sixty-eight patients improved after the percutaneous gallbladder drainage, 10 patients died from co-morbid disease and 2 patients died from biliary peritonitis. During a 1 year follow-up, 32 of the patients underwent interval cholecystectomy, 4 additional patients died from a co-morbid disease, 18 patients did not suffer from any gallbladder symptoms, and 14 were lost to follow-up.

CONCLUSIONS:

Percutaneous cholecystostomy is an effective contribution to the treatment of acute cholecystitis in high risk patients.

PMID:
12725134
[PubMed - indexed for MEDLINE]
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